HomeMy WebLinkAbout0001170-Plumbing (bathtub & lav)
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PLUMBING PERMIT - \1$hkosh, Wisconsin Permit N?
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Lot No. Block Ward Addition or Replal
OUTSIDE WORK
117Ó~
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Dale
NSW SEwn WATE. STORMS FE" fElS .ElAY S. SEWE. WATE. STORMS fElS
From MaiD to Curb Septic Tanks From Main to Curb
From Curb to Building Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
UP.
NO.
.EP. I USED
fE..
FE"
1<0.
NEW
.EP.
USED
NEW
USIO
FEES
L
/
V'
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Conductors
Catch BolDs
BaIb Tub
Garbage DilpooaIs
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Dilhwashera
Wuh Basin
WaiN Cl_t
Laundramals
Grease Calch BolDs
Sink
Waler Softeners
Sump Pump 8< Ejectors
f--'-
Waler Healers
Sanitary Bubblers
Bar and Soda Wotes
ShoWN Baths
Urinals
noor DrÚIII
Dental Cuspidors
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Laundry Tubs
Service Sinko
Inspections
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Fee Verified. Receipted and Recorded
Received Permit and Inspection Fees
---------------------Sewer Foes
---m_;?!.9?_----Plbg. Fees
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City T,....,",
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In the performance of this work the undersigned owner (or his authorired agent) of said premis.. and his authorized Plumber hereby agree to be bounden by end
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 the uJ'perslgned that no other uses will be made of the above connections except as herein"t.r listed.
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STATE OF WISCONSIN)
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WINNEBAGO COUNTY
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being first duly sworn 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 work in a ;,ome owned ¡¡nd occupied by him, or a home
that is being constructed that is owned by him, and which will
be cccupieci by him as his home when completed, That he is not
building said hO'H) 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 'i'iscop~d.n, which provides that all plumbing work
must be done by a licensed plumber except that the plumbing work
may be done by 01'(" vho owns and occupies his own home providing
the installation complies with the plumbin~ code of the City of
Oshkosh and the State of Wisconsin.
This affi~nt understands that the Plumbing work authorized
by the permit appHed for; must be done only by this. affiant and
that he cannot ~nplov others who are not licensed plumbers to
assist with the work,. -
Dated this -+-- day of -~---~-----, 19J¿
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Subscribed and sworn to before me
this jl..1£ day of ~- -' 19.2.£:_,
ÑÕtary Pubïic ~e~¡j'j )¡.eb. f:~cõnsrñ-
tññ~ COMMISSION EXPIRES
My Commission EXDires; JULY 20,1981
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