HomeMy WebLinkAbout0008612 P
~
,
)
)
lIame'
of
~r
, . " PLUMBING PERMIT - Oshkosh, WiSC:Oð"in'" Permit N~ 8612
--......_.D_1¡(Mf?c.-------..----..-.....-----,- :::::r -------~~h~------------------,------ :~tr --./J'-rZ6,~,,----d----~I:--
I Lot 110. I Block 1 Ward
OUTSIDE WORK
I Addition or Repla!
Date
NEW SEW" WATER STORMS FEES 'EES RELAY S. SEW'. WATER STORMS "ES
From Main to Curl> Seplic Tank. From Main to Curb
From Curl> to Building Electric Pumps From Curb to Building
Rapair
INSIDE WORK
NO. NEW RIP, USiID RES NO. ",w R'P. USE. "'S NO. N'W R'P. US,. 'EES
- -
Bath Tub G81'bag" DiIpœa!s C- Basin.
Wuh Basin Diahw...hers Conductors
I; - /"00
Water Cloøet LaundrWllats Greus Catch Basm.
SIIIk / l_ð6 Water Bottene.. Sump Pump 8£ Ejectors
1- - -
Water Heate.. Sanitary Bubblers 581' and Soda Wastes
Show... IIathI 'Urlnills
--
Floor DraIDs Dental Cuspidors
LellDcIry Tubs Service Sinks
IJllpectiona ltr~:~:_~;;,~:~~_:: ~::~:::~ Fee Verifisd. Receipted end Recorded Received Permit and Inspection Fees
----------- --------- ----Outside yY------..,-------_----Sewer Fees
-----¡Yìr1-r.,__.._Wlð.e ._À-..Q.Q----'pIbg. F...
$_...._.._-----_..~--_..__._----.------_..---------- D~:-!~~;t~ ~
=-j flJ. -;~ 0; $---------------,..---..,....--------------- ---------------------cliÿ-ir';;'~rë;-"-"----"'-------
In the performance of this work the undersigned owner (or his authorized agent) 01 said premises and his authorized Plumber hereby agree to be bounden by MId
.ubmlt to all statutes, city ordinances, and rulos and regulations prescribed by Ihe Board of Public Works for the government 01 Plumbers,
It is luther agreed by the undersigned that no other uses will bo mode 01 the above connections except os herelnalter lisled,
--;Z]~~~~~:~~~:::~:_-_:::~:~:::_::,~:'~:_:::::
. Plumbing In,pee."
u~~ ~~~
------7/"'" ...... ,-- ......... ----~~, ---- ------------- -------------..... ..--... ...---...-------...--
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY)
_--2i!1?/fii_4J¡;;!? ¡J -----~--- '
\!\¡ame I
(2.25 AI, /114"/
. --rÃdff~ëššT-----------
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 ng 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 occupieci by him ",5 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 V'lisconsin, which provides that Elll plumbing work
must be done by a licensed plumber except that the plumbing work
may be done by art! vho 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 a~fi3nt understands that the Plumbing work authorized
by the permkt applied for, must be done only by this affiant and
that he cannot emplo~/ others who are not licensed plumbers to
assist with the work,
!
My C;;oiY'mission
-',I',