HomeMy WebLinkAbout0001050-Plumbing (laundry tub)
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PLUMBIN\';PE~MIT - Oshkosh, Wisconsin Permit N? 1050
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I Lot Bo. 1-=:---1 Ward
OUTSIDE WORK
l- Addition or Replat
Date
NEW SEWEI WATE. STORM. .... FEE. .ELAY S. SEWE. WATE. STORMS FEE.
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
From Curb 10 BuDding Electric Pumps From Curb 10 BuUdlng
Repair
INSIDE WORK
NO. NEW RE'. USEO FIlS NO. NEW .EP. U.EO FEE. "O. NEW .EP. U.E. ....
- - - - -
BathTub Garbage Dispooala Ca!cb BasiDI
-
Wasb BuiD Dishwashers Conduclo"
- - - - -
Water CI_I Laundramll!s Grease Catch BasiDI
-
Sink Water Soflene.. Sump Pump" Ejeclors
Wll!er Heate.. Sanitary Bubble.. Bar and Soda Wasles
Shower Ba!he UriDaIs
--- - -
noor Drains Denial Cuspido.. -
I Laundry Tube V 1,00 Service SiDb
Inspecliona Valuation of Ihe Work HereiD Described Fee Verified. Receipled and Recorded Received Perml! and Inapeclion F-
--.......-....................-....................Oullide $I{)().~..............................._................... ............................Sewer Fees
..................................._...............-....Inslde ..../,..<t9...........Plbg. F..s
$...........................................-...........................-- ...L.~..ð..()...........Tolal
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In the performance of this work the undarsigned owner (or his authorized agent) of said premises and his authorized 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.
It Is futher agreed by:;ihe undersigned that no other uses will be made of the above connections except as hereinaftor listed.
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Plumbo,
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STATE OF WISCONSIN)
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\ Name i
W;INNEBAGQ COUNTY
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being first duly swcrn on oath deposes and says that he is not
a licensed plumber, and that he has applied for a plumbing
permit to the Plumbing Inspector of the City of Oshkosh, to do
plumbing wok in a home owned and occupied by him, or a home
that is being constructed that is owned by him, and which will
be occ\lpieci by him ~,s his home when completed. That he is not
building said heme for the purpose of sale.
This affidavit is made for the purpose of complying with
the provision,; of the plumbing code of the City of OShkosh and
the State of V"isconsin, which provides that all plumbing work
must be done by a licensed plumber except that the plumbing work
may be done by one ~ho owns and occupies his own home providing
the installation complies with the plumbing code of the City of
Oshkosh and the State of Wisconsin.
This affiant understands that the Plumbing work authorized
by the permit applied for, must be done only by this affiant and
that he can".o"; E)C1ploy others who are net licensed plumbers to
assist with the work.
Dated this _..d4.- day of
~~Jl~~Æ?f--"---' 1 9 -7Í-
1~-------
Subscribed and sworn to before me
thi~~aß1£l~ day of ~~9~=~___-
Notary Public, W' n~~ounty, Wisconsin
MY COMMISSION EXPIRES
My Commission. Expires :_---_:.~~~ 20,_::~:.._._----