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Name
of
PlumbeR
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LL_ot~N~O' I Block I Ward I Addition OR Replal
OUTSIDE WORK
Ðaie
NEW SEWEI WATER STORMS FE" FEES RELAY S. SEWER WATER STORMS FE"
From Main to Curb Septic Tanks From Main to Curb
~m Curb 10 BuDding Electric Pumps From CURb to Building
Repair
INSIDE WORK
NO.
UP.
NEW
USED
II"
NO.
NEW
REP. I USED
FEES
NO.
NEW
REP.
USED
FE"
Baib Tub
Garbage ÐilpooaIs
Catch Buios
f--
Wuh Basin
Ðishwash...
Conducton
Wai.. CIOI8t
Laundramais
Grease Caich Basins
f--
l
v
I/.a
Sump Pump 8< Ejecton
f-----.-
Sink
WaieR Softene..
WùøR Heaien
Sanitary Bubble..
Bar and Soda Wastes
Show.. Baths
URinals
n...... Ðralu
Dental Cuspidon
-~-
Laundrr Tubo I I I I Service Sinks
Inspøclions Herein Described Fee Verified. Receipted and Recorded Received PermU and Inspection Fees
------m------------------m---.----------Oulslde -.._..~--~------Sewer F-
.-----------____._m-____---------------______m-----Inside ___m_____----______m_____m__- -_/'_o._-Q----------PIbg. F..s
--------_.______m_--____m~1nal OK I :-_::_:::::::::::::::::::-:::::::::::::::::~-::::~::~~~:_::::::::=~ -.._~---m_-ëΡŸ-¡;;;;";o;---'--------------------' Ð~~~-'--~.i;;7;;aI
In the performsnce 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.
It Is futher egreed by the undersigned that no other uses will be made of the above connections except as hereinafter listed.
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