HomeMy WebLinkAbout0008653-Plumbing (kitchen)
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, PLUMBING PERMiT - Oshkosh, Wisconsin Permit N~ "~3
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I Lot Jlo. I Block I Ward IAddilion or Replat
OUTSIDE WORK
Dale
NEW SEWn WATER STORMS '.ES "ES ..LAY S. S.w.. WAT.' STORMS ,..S
From MaIn. to C....b Septic Tanks From Main to Curb
""'m CU1'b to Building Eleclric Pumps From C....b 10 Building
Repair
INSIDE WORK
NO. NEW REP. USED FI.S NO. NEW .... US.. ,..S NO. NEW REP. USE. FEES
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Bath Tub Garbage DilpooaIs C_BasImI
- - ¡----- -
Wuh Buin Dishwashers I I-'- Conductors
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Waft CI_t LaundrmnUli Grease Caleb Bolns
SIIIk / Waer Softe"ers Sump Pump 8< Ejeclors
Wilier He8ien Saniiuy Bubblers Bar and Soda Wasles
lbo1m' BatIuI Urinals
Floor Ðralns Dental Cuspidon
Lalllldrr Tubs Service Sinks
InspecilOIlS Valuation of Ihe Work Herein Described Fee Verified. Receipled and Recorded Received Permit and Inspection Fees
-----------------. ---.- OuIsIda $.__3..()-ç¿---~--_._--_..__._._--_._.._---- "--'-'-__---¿;:o-Sewer Fees
--------------------------Inslde ---"'-~:_-~-.:ï5._PJbg. Fees
-------------- $------------------...------.--..-..-..---....---.-.- -----,,;{-,--------..Tola
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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.
It is futher agreed by the undersigned that no other uses will be made of the above connactions except as hereinafter listed.
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STATE OF WISCONSIN)
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WINNEBAGO COUNTY
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\Address
being first duly sworn on o~th deposes and says that he is not
a Licensed plumber. and that he has applied for a plumbing
permit to th,,", Plu\nbin'J Inspector of the City of Oshkosh, to do
plumbing work in a home owned and occupied by him, or a home
that is being constrvc"ted that is owned by him, and which will
be occupieci by him as his home when completed. That he is not
building said heme for the purpose of sale,
This affidavit is made for the purpose of complying with
the provisions of the plumbing code bf the City of Oshkosh and
the State of Wisconsin, which provides that all plumbing work
m\Jst be done a l;icensed plumber except that the plumbing work
may be done by one vho owns and occupies his own hqme providing
the installation complies with the plumbing code of the City of
Oshkosh and the State of Wisconsin.
This affient u~derstands that the Plumbing work authorized
by the perœit appIicòd for, must be done only by this affiant and
that he cannot mnplov others who are not licensed plumbers to
assist with the work. ///., /// ....-----'
Dated this :;;;;i!.1._- day of ---c.r-~:!:4-----...,~.."...' 19.2J,..
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Subscribed aQd sworn to before me tf
thisc:2i day of ~~7~ 19_Z-[:
ÑÕt~w~~~nsrn
My Commission Exoires: /.2 -c2g::--?s--
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