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PLUMBING PERMIT - Oshkosh, Wisconsin Permil N? 9248
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Dlde
I Lo.I Ko.
r Block I Ward
I Addition or Replat
OUTSIDE WORK
NEW SEWEI WATER STORMS IE" lEES RELAY S. SEWER WATER STORMS IE"
From MaIn to Curb Septic Tanks From Main to Curb
From Curb 10 BuUdlnll Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
II'.
NO.
NEW
REP. I USEO
NO.
NEW
USEO
IE"
REP.
IE"
USED
FEES
BIdb Tub
Garbage DilpooaIs
Catch BasinR
f----------
Wash Basin
Dilhwashers
Conductors
Wider Cloeet
Laundramats
Grease Cldch BasinR
Sink
7
-
Io/_œ
Sump Pump" Ejectors
Wider Softeners
Wider Heate..
Sanitary Bubblers
Bar and Soda Wastes
Shower BIdhs
Urinals
noor DrIl1na
Dental Cuspidors
Laundry Tube
Inspections
Service Sinks
Valuation of the Work Herein Described
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Fee Verified, Receipted and Recorded
Received Permil and Inspection Fees
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n_#I.LQ_Qm_----__Total
Date Ç/,1/7<&
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C;ty T....u..,
$000______000___-_"-_'--_____000___--____'___000______----------000_-----
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 regulations prescribed by the Board of Public Works for the government of Plumbers.
II Is futher agreed by the undersigned that no other uses will ba made of tho above connections except as hereinafter listed.
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PlumbIng In.po<tO.
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. ðv/V'er
STATE OF WISCONSIN)
) SS
WINf\!EBAGO COUNTY) 71-
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~ '(Name¡ \Address¡
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 Inèpector of the City of Oshkosh, to do
plumbing work in <J home owned and occupied by him, or a home
th<Jt is being constructed that is owned by him, and which will
be occupieci by him é,S his home when completed. That he is not
building sdcl ho"" fer the purpose of sale.
This affidavit is made for the purpose of complying with
the provisions of thrc plumbing code of the City of Oshkosh and
the State of 'i'isoonsin, which provides that all pl\.1mbing work
must be done by a licensed plumber except that the plumbing work
may be done by oce vho owns and occupies his own home providing
the installiJt5.on CQ\TpJ.ies 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 permit applied for, must be done only by this affiant and
that he canr.ct £,,'>plo" others who are not li<:;ensed plumbers to
assist with the work.
Dot,d th1, ---'-- d" of ~. 1926,
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Subsc:r,ibed and sworn to before me
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this' day f ----' 19 --;:tp.
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