HomeMy WebLinkAbout0008435-Plumbing (fixtures)
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"lPLUMBING PERMIT - Oshkosh, Wisconsin, Permi1 N? 8435
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¡uBIOCk- - I Ward
Dat.
l Lot No.
I Addilion or Replai
OUTSIDE WORK
NEW SEWEll WATER STORMS lEES fEES R"AY S. SEWER WATER STORMS FEES
From Main 10 Curb Septic Tanks From Mom 10 Curb
From Curb 10 Building Electdc Pumpe From Curb 10 Building
Repair
INSIDE WORK
NO.
NEW
UP.
USED
FI'S
NO.
NEW
REP- ,I USED I FEES
NO-
NEW
REP-
USED
FEES
Bath Tub
7
Catch Basins
}.Of
/JJ!J
þö
tOll
/-00
Garbugo DiopoaalJJ
Wash BIIIÏD
L
/
Greue Calch Bulns
Dishwuhors
Conductors
,-,-
Wat... CI0I81
Laundi-
SID!!:
7
/
Water Softeners
Sump Pump III: Ejectors
Water Hoú....
Sani1uy Bubblers
Bar and Soda Willies
Sho.."" ,BathR
U!inaIs
Floor ~8IDS
Laundry Tubs
Denial Cuspidors
Service Sinks
~~ns -- -...-_----Oullide V~~nOof the Work Herein Described Fee Vedfied. Receipted and Recorded R~ei:~_~e::it;":.:":':ion F-
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In the performance of this work the undersigned owner (or his authorized agent) of said premis.s and his authorized Plumber hereby agree to be bounden by end
submit to all statutes. city ordinances. and rules and regulations proscribed by the Board of Public Works for the govern",ant of Plumbers.
It Is futher agroed by the undersigned thet no oth"r uses will be made of the aboye connections except as herelnafl.r lisled.
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STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY)-
! -' d
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being first duly sworn on oath deposes and says that he ;Ls 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 i) home owned and occupied by him, or a home
that is being cons~ructed that is owned by hi~, and which will
be occupied by him as his home when completed. That he is not
building said home for the purpose of ¡ale.
This affidavit is made for the purpose of Gomplyin~ with
the provisions of the plumbing code of the City of Oshkosh and
the State cf V"isconsin, which provides that all plumbing work
must be done by a licensed plumber except that the plumbing work
may be done by one ~ho owns and occupies his own home providing
the installation complies with the plumbing ~ode of the City of
Oshkosh and the State of Wisconsin.
This affiant understands that the Plumbing work authorized
by the permit applied for, m~stbedoneonly by this affiant and
that he can"ot eë1plo~1 others who are not li'censed plumbers to
assist with the work,
Dated this -d£ day of ,......~------' 19£~
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Subscribed and sworn to before me
this ~/day of -~, 19 p~
J~_1??L&t;L~ -------------
Notary Public, Winnebago County, Wisconsin
MY CU,Jlml~~I(j" ~;<.fIRE$
My Commission Expires ;__MA~l:L12. ~1§_____-