HomeMy WebLinkAbout0009920 P
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PLUMBING ~P'ERMIT - Oshkosh, Wisconsin
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I Block -_J Ward
\
Permit
Street
and
........... Number
;~rmit N~' 9920
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I Lo.I No.
l Addition or Replat
Date
OUTSIDE WORK
Naw SEWEI WA"R STORMS 'EES "ES .E'AY S. SEWER WA"R STORMS FEES
From MaIn to Curb Septic Tanks From Main to Curb
~m ClUb to Building Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
..,.
FlES
NEW
RE,. 1 USED
FEES
NEW
RE,.
fEES
USED
NO.
USED
NO.
Batb Tub
Garbage Dlspooals
Dishwashers
Catch Basilia
Conductors
Wuh Basin
1-
/
-,-
j/P-r
Grease Catch Basilia
Water CI_t
LaundrlLlDÙl
SID1I:
Water Softeners
Sump Pump 8< Ejeclors
Water Heaten
i/
I/~
Sanitary Bubblers
Bar and Soda Wastes
Shower Baths
Urinala
ncor DraIDs
Dental Cuspidors
Laundry Tube
Service Sinks
~:~:.:_................................Outside
Valuation of the Work Herein Described
Fee Verified. Receipted and Recorded
Received Permit and Inspection F-
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D~:"""i)ß/h 7
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In the performance of this work the undarsigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by and
submit to all statutes, city Drdinances, and rules and regulatiDns 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 connections except as hereinafter listed.
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WINNEBAGO COUNTY
STATE OF WISCONSIN)
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. 44/ «¿?-,---=IatÆ..---.-.-,
Name I
-..L 7 <.(0
MC/'9 ~ /k
(Addre$.ลก)
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 numbing Inspector qf th¡;¡ City of Oshkosh. to do
plumbing work in éI home owned and occupied by him, or a 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 theþurpose 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 of ~1sçonsin. which provides that all plumbing work
must be done by a licensed plumber except thé)t the plumbing work
may be done by one ~ho 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 affiant understands that the Plumbing work authorized
by the permit. applied for, must be done only by this z¡ffiant and
that he cannot employ others who are not licensed plumbers to
assist with the work,
Dé)ted this ~~ day
of _-1l.~ , 19.zz:
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Subscribed and sworn to before me
this...&.. day of .L:.~-, 19 ;;::Z
ðf¡4~1.24-.W~ . --.--
Not ry Pu ~c, W~nnebBgo County, W~scons~n
r'y CC1'fl~"!"'S¡QN E)(PI¡{E"
My Commission, Expires:~~¿';'12~:13