HomeMy WebLinkAbout0009295-Plumbing (fixtures)
---
)
"; .. PLUMBING PERMIT - Oshkosh, Wisconsin Permil N~ 9295
5- t." Name ;~ S:.<eel ., . Z/ (fl --'
of 'er of' and. /f/v
Plumber .-...h..._QJk!.J\!I....._._....--.-.-.-.................. Owner ........- .........~........._................ Number ....._....~..M"....ci.._....."'..._.h_h...mh._-
I Lei No.
I Addilic)tt or Replal
r Block I Ward
Dale
OUTSIDE WORK
NOW SEwn WATER STORMS fEES FIlS RELAY 5. SEWER WATER STORMS fEES
From Main 10 Curb Septic Tank. From Main 10 Curb
From Curb 10 BuDding Electric Pumps From Curb 10 BuUCÜJ1g
!-------
Repair
I
INSIDE WORK
NO.
NEW
u..
NEW
FEES
RE'. I USEO
fEES
"O.
NEW
RE..
USED
USED~
17~
tOe
NO.
Garbage DispoAls
CaIc:h Basins
Beth Tub
Wuh Basin
7
Conduclors
Dishwashers
711-!1 °0
1/.06
Grease Calch Basins
Water Cl_1
Laundramalo
Sink
I
7
Sanitary Bubblers
Bar and Soda Wasle.
Waler Softene..
Sump Pump Ik Ejectors
I
loe
I/.(Ú
WaUr Hoalen
Shower Balbi
Urinals
F1oor Dralnl
Denial Cuspidors
Launcl<y Tubs
Service Sinks
Inspeclions
..__00_.:. 7 - - -;;7"7 Z..... _h....... Outside
.... ...c;j..L j?j..L.. rt:....-... .-..-.... Inside
~=~WI5~::~==::;~"'~;
V~tion of Ihe Work Herein Ds.cribed
$...~..O.Q~.O....."""......__..'._.".h..._..
e
Fee Verified, Recelpled and Recorded
Received Permit and Inspeellon F-
............._-----...Sewer F...
._.~~.Q-Q._.Plbg. Foos
I!.J:ii".Ò..Ú...Tolal
Dale~.6- ~ t.;'
$..-........................... _'h...._..-"'..._m_._.'..--..
.-..""....'.(:liÿ'T;~.;ü,~;-'.'."".'_._'.'..'-'
In tho 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 ordinance., and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
I! is futher agreed by the undersigned that no other uses will be made of the above connections except as hereinafter listed.
.-...--Rt-----..;...¡:ß-..-..-... .--~.hì;';üìhÖit' '.""..;;;¡-"""""_'h"'.._""""'-"""-
=~~ß..~:. ~f.~~ _dm.-.""'" - .d...dm .m_"...._...
D.:'.L em .AIA~.........
V/~.'7..f~~ h" c .r
STATE OF WISCONSIN )
) SS
WINNEBAGO COUNTY) (5/ c:;
'¥.&~~.~èo~__- , _:&' I:; úJ:\ã~ a<J/£....~
being first duly sworn on oath depose& ~nd says that he is not
a licensed plumber, and that he has applied for a plumbing
permit to Uw Pl',)"1b:in9 Inspector of the City of Oshkosh, to do
plumbing work in a :Come owned and occupied by him, or a home
that is being constructed that is owned by him, and which will
be occupied by him ,òs his home when completed. That he is not
building said' hon'e 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"iscansin, which provides that all plumbing work
must be done by a licenSed plumber except that the plumbing work
may be done by 01",(, vha owns and occupies his own home providing
the installation coæplies with the plumbing code of the City of
Oshkosh and the ,k3te of Wis consin.
This affiant understands that the Plumbing work authorized
by the permit applied for, must be done ònly by this affiant and
that he cannot employ others who are not licensed plumbers to
assist with the work.
D,',d <hi, ..iL d,y of ~ ~
Subscribed and sworn to before me- . .:)..
this dL::~~ b 19 J~-~---
Notifv~lic, Winnebago County, Wisconsin
. MY COMMISSION EXPIRES
My Commission,Explres:__MAft~_~~_----- '
,"