HomeMy WebLinkAbout0001004-Plumbing (lav & toilet)
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L~o.".--- I Block I Ward IMdilion or Replal
OUTSIDE WORK
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of
Plumber
Daie
NEW SEW" WATER STORMS FEES FEES RElAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
!'10m Curb ID BuDding Eleclric Pumps From Curb 10 Building
Repair
NO.
NEW
"P.
USEII
flES
NO.
Bath Tub
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Wuh Bum
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Wai8r Heale..
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Laundry Tube
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INSIDE WORK
NEW
REP. I USED
FEES
NO.
NEW
REP.
USID
fEES
Garbage Dilpooa]s
CIIIch Basins
Dishwashers
Conducloro
Laundrama18
Greue Calch Basins
Waler Soflenero
Sump Pump" Ejeclors
Sanitary Bubblers
Bar and Soda Wasles
Urinals
Dental Cuspidors
Serviee Sinks
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----.........----..----..------------------------------Oullide
---..------.........---..............---..----------------Inslde
-....--..--..-...-----------.....FiDal OK
Fee Verified. Receipled and Recorded
Received Permit and Inspaellon Fees
- ------....------------Sewer Fees
--..!£..QQ.-----....Plbg, Fees
-,..ILO:O------.....Tolal
Dale /-6= 7Y
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In the performance of this work the undersigned owner (or hi. authorired agent) of said premises and his author ired Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances. and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
undersigned that no other use. will be made of the above connections except as hereinafter listed.
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