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HomeMy WebLinkAbout1975-Plumbing (fixtures) ~ ì / Name of Plumber :/UfMBING PERMIT - Oshkosh, Wisconsin .. \ ¡>Jrmü N? 8252 -~----------_..._--- ::!:r ~~---d~---------------------- :::t. -__j~~¿L7n~~ I Lot No. -I Block I w~___f_Addilion_or Replat Date OUTSIDE WORK NIW SEWER WATER STORMS FEES FEES RELAY S. "WER WATER STORMS FEES From M8ID to Curb Septic Tanks From Main to Curb - !\rom Curb In But1cIing Elecl,,;c Pumps From Curb to Building Rapair ~ INSIDE WORK NO. NEW UP. USEO FlES NO. NEW REP. USED FEES NO. NEW REP. USED FEES ~ - - ~ BUb Tub I /ur) Garbage DÏ8poiIaIa Catch Basins - Wash Buin I II. qr;) Dlshw...hen Conductors - - ~ W- ClOl8t / II. rlJ Laundr- Gre..... Caich Bums SIDII: Water Soften...s Sump Pump 8< Ejectors W- Heate.. Sanitary Bubblars BII1' and Soda Wulas Shower Baths Urinala FloĊ“ DraIDs Dental Cuspidors Laundry Tubs Service Sinks Inspections Valuation of the Work Herein Described Fee Verified. Receipied and Recorded Received Permit and Inspection F..... --.---..-.------.--Ontside $_.s..aû:...~_....._----_.._.._._.- -.-.--.--------Sewer Fees ~-"'-~3Ii1i--~~ ----¿) '-~-"'pIbg. F..... $----------------...-------...--...-----..----- ._---....L.~--Toial -- - --=----..Final OK $--------...------...------------------- -----"'-"'---------Cliÿ--T.;~'~;;;-----"'--------- Date 1/- ;2.d. . l.s---' In th.. performance of this work the undersigned owner (or his authorired agent) of said premls.. and his authorized Plumber hereby agr.. to be bounden by and submit to all statutes, city ordinances, and rulas and regulations prescribed by Ih. Board of Public Works for Ihe government of Plumbers. It is futher agreed by the undersigned that no other uses will b. mad. of th.. above <onnectlons except as hareinúter listed. =~~~;~~::::~=:-:-:-::=::::::--~_:=:=::: ,/ ,-, "~ . ..., STATE OF WISCONSIN ) ) SS ) WINNEBAGO COUNTY ~ f?i~ (Name Jr2¿J¿J ~~~Æ (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. Dat ed this -Æ"Y~~, Subscribed and sworn to before me this ~ day of ~, 19;Z:f /" . ~~ Â7#.~ . - Notary Public, Winnebago County, Wisconsin MY COMMISSION EXPiRES My Commission Expires: MARCH 12. 1973