HomeMy WebLinkAbout0001589-Plumbing (fixtures)
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I, PLUMBING .PERMIT - pshkosh, Wisconsin Permit" N? 1589 Lt
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I LoJ No. I Block I Ward I Addi!ion or Replat
OUTSIDE WORK
Date
NEW S'W" WATER STORMS FE'S FEES RElAY S. SEWER WATER STORMS fEES
From MaIn to Curb Seplio Tanks From Main to Curb
~ Curb to BuUding Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
REP.
NO.
NEW
R'P. I USED
NO.
NEW I R'P.
FEES
USED
fEES
USED
FlES
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1
I
Beth Tub
Garbage DiopoIa\I
Catch BaslDs
./
V
Wash Basin
Dishwashers
Conductotl
Gre... Catch BaslDs
Laundramats
Water Cl_t
f---
Sink
Water Softenetl
Sump Pump II< Ejectotl
Wmr Heate..
Sanilary Bubhletl
Bar and Soda Wastes
I
v
Urinals
Sho..... Baths
noor Drallls
Dental Cuspidotl
Laundry Tube
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Service Sinks
Received Permi! and Inspection F...
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._.s'_.99mdmPlbg, Fees
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In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorirod Plumber hereby agree to be bounden by end
submit to all statutes, city ord;4nces, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
Valualion of the Work Herein Described
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Fee Verified. Receipted and Recorded
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STATE OF WISCONSIN)
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WINNEBAGO COUNTY
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 and occupied by him, or a home
that is being constructed that is owned by him, and which will
be occupied by him '9~ his hom€ when completed. That he is not
building said home for the purpose of sale.
This affidavit ismad~ for the purpose of complying with
the provision<1 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 except that the plumbing work
may be done by onE! vho owns and occupies his own home providing
the installation colrpJ.ies with the plumbing çode of the City of
Oshkosh and the ::"j>3te cf Wis consin.
This affiant understands that the Plumbing work authorized
by the permit applied for, must be done only by this affiant and
that he can~ot employ others who. are not licensed plumbers to
assist with the work.
Dated this --L_- day of ~&~-----, 197-;!:
ß _2J.~_;¡:5i. LZ1.~:"_---
Subscribed and sworn to before me ' ~
this
day of -----------' 19_---,
Notary pubïíè-;-wlññë5ãgoÕõûnty-;-iiiIšëõnsIn
My Commission Exoires:
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