HomeMy WebLinkAbout0001353-Plumbing (bathroom fixtures)
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PLUMBING PERMIT - Oshkosh, Wisconsin .'" Permit NI? 1353 X
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I Lot Ho. I Block I Ward
OUTSIDE WORK
l Addition or Replat
Date
NEW SEwn WATER STORMS fEES fEES RElAY S. SEWER WATER STORMS fEES
F- MaIn to Cub Seplic Tanks From Main 10 Curb
nom Cub to BuUdlng Eleclric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
NEW
UP.
NO.
NEW
fEES
NEW
fEES
REP.
USED
REP. I USED
NO.
USED
flES
Beih Tub
Gubage DiIpoAIs
Catch Basins
Wash Basin
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l{~
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f--
Dishwashers
Conduclors
Grease Catch Basins
Launcl2amaIR
Wat.. Cl_t
Sink
Water Softeners
Sump Pump" Ejectors
Water Heate..
Saniluy Bubblers
Bu and Soda Wasles
Show.. Baths
II
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Urinals
n..... DoaIJIs
Denial Cuspidors
Laundrr Tubs
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Service Sinks
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Valuation of Ihe Work Herein Described
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Fee VerUled. Recelpled and Recorded
Received Permll and Inspecllon F-
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S. .:>/0
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----...-..--...------------Final OK
In the performance of this work the undersigned 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 rogulations proscribad by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be made of the above connections except a.s hereinalter lis
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PlumbIng Ino"""
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STATE OF WISCONSIN)
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\1\ame; Addre~s
WINNEBAGO COUNTY
being first duly sworn .on oath depose~ and ~ay~ that he i~ not
a licensed plumber. and that be has applied for a plumbing
permit to the Plumbing Inspector of the City of Oshkosh, to do
plumbingwor~ in a home owned and occupied by him, or a home
that is being constructed that is owned by him, and which will
be occupied by him 35 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 cf V.'isconsin, which provides that all plumbing work
must be done by a licensed plumber exce~t that the plumbing work
may be done by one vho owns and occupies his own home ~roviding
the installation coæplies with the plumbing code of the City of
Oshkosh and the State of Wisconsin.
, This affi~nt understands that the Plumbing work authorized
by the permi ê1pfJlicoeJ for, must be done only by this affiant and
that he ca nc1plo~1 others who <;ire not licensed plumbers to
assist with -Nork, ~
Dated tUs 1-- day of ----_J_c¿~_::::- ----' 1 92F'
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Subscribed and sworn to before 'me '----'" ~ {j -
this -~ day of -~~---, 192~.
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Notary PubÍ',f~" w~ntt8<Jo County, ~!isconsin
MY COMMISSION EXPIRES
My Commission Exoires: JULY 20,1981
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