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j PLUMBING PERMIT - Oshkosh, Wisconsin ~'permit N? 1588 ~
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I Block I Ward
I Lot Ho.
I Addition or Replat
Dale
OUTSIDE WORK
--
NEW SIW" WATER STORMS ...S FEES RELAY S. SEWER WATIR STORMS FilS
From MaIn to Curb Seplic Tanks From Main to Curb
From Curb to BuDding Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
NO.
NIW
fEES
FEIS
"0.
NIW
REP. I USED
REP.
USED
UP.
US"
FE"
I
./
Garbage Dis~
Caleb Basins
!-----
BaIb Tub
Wuh Basin
Dishwashers
Conductors
Waler Clooet
Laundramals
Grease Calch Basins
f--
L!
Sink
./
Waler Softeners
Sump Pump Be Ejectors
[i"""'-
Waler Heale..
Sanilery Bubblers
Bar end Soda Wasles
Show.. Baths
Urinals
Floor DraIDI
Denial Culpidors
Laundry Tubs
Iuped1ou
Sernce Sinks
Fee Verified, Receipted and Recorded
Valuation of the Work Herein Delcribed
SðC)(2~---____----------------_...--.__._-------------
S---------------------.---.----------------------------------------------...
S-------------------------------------- -------------------------------
Received Permit and Inlpecllon Feee
-------.------------.----.--Sewer F-
-----~_"':P.----_Plbg, Feel
D~~:e?~777
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City T,...u,.,
--------------------------Final OK
In the performance of this work the undersigned owner (or his authorired agent) of said premises and his authorlred Plumber hereby a~ to ba bounden by and
submit to all statutes, city ordin eel, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
erslgned that no other uses will be made of the above connections except as hereinalter listed.
4~---.__'iJ~.--
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$TATE OF WISCONSIN)
) S5
WINNEBAGO COUNTY)
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'being first duly sworn on oqth deposes qnd Sqys that he is not
a licensed plumb~r. and that he hasqpplied for q plumbing
permit to the Plumbing Inspector of the City of Oshkosh, to do
plumbing work in ç, home owned and occupied by him, or q home
that is being constructed that is owned by him, and which will
be occupieci by him3s his home when completed, That he is not
building said heme for the purpose of sqle.
This affidavit is made foi the purpose of complying with
the provisions of the plumbing code of the City of Oshkosh and
the State ofWiscons:i.n, which provides thqt all plumbing work
must be done a licensed plumber except that the plumbing work
may be done by one ~hoowns qnd occupies his own home providing
the installation COii'pJ,ies with the plumbing code of t!1e City of
Oshkosh and the State of Wisconsin,
This affiant understands that the Plumbing work authorized
by the permit appliad for, must be done only by this affiqnt qnd
that he ca employ others who are not licensed plumbere to .
assist wit~, 'Ncrk, . ¡J /J . . /
Dqted this _J_-- dqy of ~--------, 192K.
~~~---~----
Subscribed and sworn to before me
this
day of ---~------' 19____,
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My Commission Expires :_---------------------