HomeMy WebLinkAbout0008616-Plumbing (fixtures)
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PLUMBI~G "PERMIT - Oshkosh, Wisconsin' pi~i;"i! N~ 8616
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l.L_o1NO. I Block I Ward
OUTSIDE WORK
f Addilion or Replat.
Date
NEW SEWER WATE. STORMS 'EES 'EES .EIAY S. 'EWE. WATE. STORMS 'EES
From MaÜl10 Curb Seplic Tanks From. Main 10 Curb
FJom Curb 10 Building Eleclric Pumpa From Curb 10 Building
Repair
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INSIDE WORK
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NEW
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1
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USED
fIlS
NO.
NEW
.E'. I USE.
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NO.
NEW
.E.. I USE.
FEES
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/60
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II8!b Tub
Gubago DIipo<;aJs
Ctieb Basins
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Wuh BUÙI
Wale Cbet
Dishwashers
Conducto..
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Laundr.......u
Gr...... Caleb BuIDs
Sump Pump III: Ejeclors
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SIAlo:
Wale. Softene..
WaIH Heaters
SlIDiIary Bubblers
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Bar and Soda Wasles
Showe .Bùhe
UrilWa
Floor Dr"
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DentlÙ Cuspidors
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La,UlcIfy Tubs
Servï.... Sinks
I...pecIio... Valualion of Ihe Work Herein Described Fee Verified. Receipled and Recorded Received Permit and Inspeclion Fees
----.--.--..-.-..--...Oulside $ Jfj,'f. 12O. () () '-----¡r-......__Sewer Fees
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---------.-...Final OK ,$.-------.-.-------------.--------- Dale !Ó 17" I?)
In Ihe performance of this work tho undersigned owner (or his authorized agent) of said premis.s and his authorized Plumber hereby agree to be bounden by and
submit to all statules, city ordinancas, and rules and regulations prescribed by tha Board of Public Works for the government of Plumbers.
It is futher agreed by the undersigned that no other uses will be made of Ihe above connections except as herelnafler iisled.
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STATE OF WISCONSIN
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WINNEBAGO COUNTY
vÆ/lér (Jp/(r);e
(Name)
/.1',)../ O/tÎ/f;
(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.
Dated this ~ day of
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this
My Commission Expires:
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