HomeMy WebLinkAbout0008857-Plumbing (wash basin)
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~ . PLUMBING PERMIT - Oshkosh, Wisconsin Permit Nr.' 8857
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I Lot No. I Block I Ward I Addition or a.plat
OUTSIDE WORK
Dale
NEW SEW" WATER STORMS fEES FEES RELAY S. SEWER WATER STORMS fEES
From MaIn 20 Curb Seplic Tanks From Main I@ Curb
From Curb io BuDding Electric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
NEW
RIP.
USED ~I NO-
NEW
REP. I USE.
FEES
NO.
NEW
REP.
USE.
fEES
BallI Tub
Garbage Diapooah
Calch B""i...
-
Wuh BulD
/
I/PJ
Conductors
Diabwaah"".
-,-
Water CI0l82
Laundram&!s
Grease Calch Buins
SIIIk
Waler Soft.""".
Sump Pump 8< Ejeclors
Waler H8IIIers
Sanitary Bubblers
Urinllls
Bar and Soda Walles
SIJoW8rBatlus
Floor ÐraillS
Denial Cuspidors
Laundry TuIIœ
InspeciIolll ---oo-oo-Outside
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Senice Sinks
Valuation of !he Work Herein Described
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$----------------------------------
Fee Verified. Receipled and Recorded
Received Permit and Inspection Fees
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/c2 -02 9- ).~
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City ,...",.,
------------1'1nal OK
Date
In Ihe perfermance ef this werk the undersigned owner (er hi. autherized agent) of said premises and his authorized Piumber hereby agree to be bounden by and
submit to all statutes, city erdinances, and rules and regulations prescribed b~ard of Public Works for the government of Plumbors. -
und.rsigned that no othor uses wiU be made of the above conneelions except as hereinafter listed.
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"',mbe,
STATE OF WISCONSIN
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WINNEBAGO COUNTY
a.~
4 ~Jl
/ d,] (,.) j ¡;y --L~41LL
(Address)
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, 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 the purpose 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 Wisconsin, which provides that all plumbing work
must be done by a licensed plumber except that the plumbing work
may be done by one who 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 affiant and
that he cannot employ others who are not licensed plumbers to
assist with the work.
. 19?5.
Dated this ~ day of
p~,
Subscribed
t? r)/~
to befor~'
this
My Commission Expires:
Id- -02.1- 79