HomeMy WebLinkAbout0001096-Plumbing (kitchen sink)
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LPlUMBING PERMIT - Oshkosh, Wisconsin" Permit N? 1096
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I Block I Ward
r Lo.I No.
I AcI<Ii!i()~r Replat
Date
OUTSIDE WORK
NEW SEwn WATn STORMS fEES fEES RElAY S. SEWER WATER STORMS fEES
From Matn to Curb Septic Tanks From Main to Curb
From Curb to BuDding Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO. NEW UP. USED fEES NO. NEW RIP. USED fEES NO. NEW REP. USED fEES
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Batb Tub Garbage Dlopooals Catch Baaiu
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Wuh Basin Dlohwashers Conductors
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Water Cl_t Laundrama.lo Grease Catch BasiDa
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-I- Sink / I,dl> Water Softeners Sump Pump Ik Ejectors
Water Heaters Sani1ary Bubblers Bar and Soda Wastes
Shower Baths UriDa1s
Floor Dratns Denial Cuspidors
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Laundry Tubo Service Sinks
Il1Ipections :;;~::.=:r.::: :::.::::.:: Fee Verified. Receipted and Recorded Received Permit and Inspection F-
..-....--.....-----......-........-.-......Outside .....-............---.....Sawer Fees
..................---...---.....-.......---..-....Inside ...L~....._._Plbg. Fees
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..----.---.-.--...-..---FiDal OK $..........-.......---.......-..................-............--..-...
In the performance of Ihis work Ihe undersigned owner (or his authorired 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.
the undersigned that no other uses will be made of the above connections excepl as hereinan,r .listed.
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STATE OF WISCONSIN)
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W¡NNEBAGO COUNTY)
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\Address}
being first duly sworn on oath deposei and says that he is not
a licensed plumber, and that he has ~pplied for a plumbing
permit to the Plu~bing Inspector of the City of Oshkosh, to do
plumbing wcrk in ç, horr,e owned and occupied by him, or a home
that is Þeingconstructed that is owned by him, and which will
be occupieÔ by him as his home when completed. That he is not
building said home for the purpose of sale.
This affidavit is made for the purpose of complying with
the provisions 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 Statecf Wisconsin.
This affiant understands that the Plumbing work authorized
by the. permit AppJ.ied for, must be done only by this affiant and
that he cannot employ others who are not licensed plumbers to
""';,:::\::: W01-- d,y of ~~. 19;L.
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Subscribed and sworn to before m~. ... .
this -W day of ~fM.cl_--, 19J.t.
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Notary pu~~, ~bago CountVA NWL~~iDsin
. MY COMMIS"IO EXPIRE';
My Commission. Expires;__--:~~:~~19B:_--_-