HomeMy WebLinkAbout0001216-Plumbing (water heater)
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Name
of
Plumber
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I Lot No. I Block I war: IAddiiion or Replst
OUTSIDE WORK
Date
NEW SEWEI WAUR STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MelD 10 Curb Seplic Tanks From Main 10 Curb
~ Curb 10 BuDding Eleclric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
UP.
FEES
USED
FIlS
NO.
NEW
NEW
REP. I USE.
FEES
NO.
NEW
REP.
USED
Batb Tub
Garbage Dilposals
Catch Buw
Wuh Bum
Dishwuben
Conduclor.
I~-
Water CI_I
LRUndzamats
f---
Greue Catcb Buw
Sink
Water Softeners
Sump Pump Ik Ejeclors
(
v
Bar and Soda Wasles
I¡,cð
Water Heate..
Shower Batba
Sanitary Bubblers
Urinals
F1oor DraIDs
Laundry Tubs
Denial Cuspidors
Service Sinks
InspecI1ons .-........Oulside
~::-'~::::::::::~~~::==:~~:=:=::::...._........Inside
Valualion of Ibe Work Herein Described
$Q(oO~......................._.._..............-
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Received Permi! and Inspeclion Fees
........................Sewer F-
......P.Ct9......PIbg. F...
D~~:"Ú~;h /
Fee Verified. Receipled end Recorded
...................................-..................-....
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-Final OK
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CIty T,..",.,
In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby eor'" 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.
It Is futher agreed by thnnderslgned that no other uses will be mede of the above connections except as hereinafter listed.
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PlumV'
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