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PLUMBING PERMIT - Oshkosh, Wiscónsin ' Permit N'? 565
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I Block I Ward
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I Lot No.
l Addition or Replat
Date
OUTSIDE WORK
NEW "'WEt WATER STORMS 'EES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Septic Tanks From Main to Curb
~ Curb to Building Electric Pumpt From Curb 10 Building
Repair
INSIDE WORK
NO. NEW u,. USED FlES NO. NEW RE,. USED FEES tlO. NEW u,. USED FEES
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BathTub L Garbage DiIpoAla Catcb Basins
1- - ~
Wub Basin / /ø- Dlsh.ashen 1- Conductorl
/::;~ - ~ - ~
Water CI_I / Laundramattl Greue Catch Basins
+-.-
SIDk Water Softener. Sump Pump" Ejectors
Water Heaten Sanitary Bubblers Bar and Soda Wastes
Shower Baths Urinals
Floor Drains Dental Cuspidon
- -- ~
Laundry Tubs Service Sinks
Inspections Valuation of the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Fees
------ ---..------ .-_.-. --..----. -.-. -------Outside $..---...7"'QçQ...K---.-fÖ...Ð..-.--.---..........-, ~~::q:Q:::::n::r F:7
--.-----.------.--------.----.-----..-.-.--....----Inside
..---------------------.---....-.----.--.----- $---..-------.-..-----...-----------------..-..---.---..-.-...----. D~~-----?;Ç)-;h 7
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----------.----------------Final OK $---...----....-..-..----.---... ...------.-----.--------.-..-----
In the ptrformence of thi. work the underoigned owner (or hi. authorized agent) of said premises and his authorired Plumber hereby agraa to ba bounden by and
.ubmit to all statutes. city ordinances. and rules and regulations prescribed 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 connectio~cept as hereinafter listed.
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STATE OF WISCONSIN)
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WINNEBAGO COUNTY)
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(Name ì
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.LClke
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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 home owned and occupied by him, ora home
that is being constructed that is owned by him, and which will
be occupied by him as 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 th~City of Oshkosh and
the State of i¡'.'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 complies 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 ca f¡c,plov others who are not licensed plumbers to
assist with ~crk,
Dated this ;;)-1..- day of ----~c<f------:' 1922
~~-
Subscribed and sworn to before me
thb §9ft day of --~---, 19-2.2.
Nota ry ~~~~~:--WIšëQñšrñ-
My Commission Expires :_~~jJJl¿-----
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