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PLUMBING PERMIT - Oshkosh, Wisconsin Perml! N~ 8614
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LLoJNO. I Block I Ward
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OUTSIDE WORK
NIW SEW" WAT.. STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaiD to Curb Septic Tank. From Main 10 Curb
From ClUb Ie Building Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO. NEW II'. USED FlSS NO. NEW R". .Si. "E' NO. NEW REP. USE. FEES
-
Bath Tub Garbag" Diapooala Catch Basins
Wuh Buln Diah......hon Conductors
- - -
Water CIoN! Laundr- Crease CoJch BuiDs
SIDk Water Softe....rs Sump Pump II< Ejectors / V.po
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WOI.t8r Heaton / /~ Sanitary Bubblers Bar and Soda Wastes
Show.. Baths UrInsle
Floor DraIDs / /~ Dental Cuspidors
LaUILdry Tuba / /~ Service Sma
IDIPOCtiW- /2.i. Valuation of the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Fees
--- :LJ. /2 -..-----Outs1cle $......_¿-~...o..--.Q....!:...~P"..__...- .--nn...-...-.--..-SeWer Fees
_...._----~....__Jnside £9---9..__Plbg, Fees
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---+-1--::;. -~----FInal Ole $---- ..-..-- - -- -"-__'___n'_.n_nn. _n_n- -............n"'_'c'iŸÿ;.;;,;;;;_n__._...n.........
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In the performlnce of this work thl undersigned owner (or his authorized agent) of said premi.es and his authorized Plumber hereby agree to loa bounden by and
submit to all statutes, city ordinances. Ind ruiN Ind regulations prescribed by the Board of Public Works for the govern",e..t of Plumbers.
It is futher agreed by the undersigned that no other uses will be mode of the above connections except .s here¡"ofter Ii,ted.
Mr. David Constantine
1265 Greenfield Trail
Oshkosh, Wisconsin
PLU}ffiING INSPECTION AFFIDAVIT
CERTIFICATE OF COMPLIANCE WITH
STATE OF
Ihsconsin
PLUHBING CODE
I, HEREBY CERTIFY THAT ALL PLU!1BING IN BATH CORE SERIAL NO. 75-323,
INSTALLED WITHIN A WICK.HO~ΠIS IN ACCORDANCE WITH THE STATE OF
Wisconsin
PLUMBING CODE.
ALSO, THAT THE DRAINAGE AND VENT
PIPING HAS BEEN WATER TESTED IIIITH 4.35 LBS./SQ. IN. OF HEAD PRESSURE
FOR A PERIOD OF ONE-HALF HOUR.
THE'..IATER SUPPLY PIPING HAS BEEN TEST-
ED Wlr-rl MAZOè~NIE, WISCONSIN CITY WATER PRESSURE (APPROX: 90 LBS.)
FOR A PERIOD OF ONE-HALF HOUR.
DATE
November 19,1975
{D~( W(J ~ (lt~L(
SIGNATURE
MASTER PLUMBER
TITLE
5477
LICENSE NO.
SUBSCRIBED AND SiveR!'! TO BEFORE ME
r-rlIS 11 tI .
19£. ¿f,{! J
NOTARY PUBLIC, DANE COUN' ,WISCONSIN
MY COMMISSION EXPlRESí/;/ , 19...21.
DAY OF l¿iil'¿"""'t..c