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c' ¡conlin Permit N~' Z;¡3
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Date
I Lot No.
OUTSIDE WORK
NEW SIWEI WATER STORMS 'EES "'S RELAY S. SEWER WATER STORMS FEES
From MaIn to Curb Seplic Tanks From Main 10 Curb
From Curb I!o Building EI.ctric Pumps From Curb to Building
Repair /' f( / tJ-V
INSIDE WORK
NO. NEW l1li. USED FIlS NO. NEW RE'. USE. FEES ~I NEW REI. USE. '.ES
Bath Tub Garbag" DiIpoaaIJ Catch Basim
Wub Buln Dishwuh... Condudo..
1-
Wat. Clout Laundr- Gr...... Catch Bulna
SIaJc Water Softene.. Sump Pump & Ejedors
Water Heate'" Sanitary Bubble... Bar and Soda Wules
Dho- Baths UrinaJs
Floor DraIDa Danlal Cuspido...
LaW1dry Tubs Serrica Sinks
IDlpec!ioll8 Valuation of Ibe Work Herein Described Fee Verified, Receipled and Recorded Received ~mit and Inspeclion F-
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..----.--..-.-----_c.--...-IllEide :~.::2~:~~::~ Fees
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------...--....-------F1naI OK $--------...---------....--------..---.....- --------"""""'----ëi¡:¡Ÿm,û;ë;-"'--"'---"""---- Dale /1-::10- 75---
In th. performance of this work the undersignod owner (or his authorized agent) of said premises and his authorized Plumber hereby agr.e to be bounden by and
submit to all statutes, city ordinances, and rules and regulaiions prescribed by I'he Soard of Public Works for the g<>vernment of Piumbers.
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