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JI'..... - 9 /-:: PLUMBING PERMIT
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Ward
Permit N<.? 9522
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¡ Lot No.
[ Addition or Replat
Date
OUTSIDE WORK
NIW SEW" WATER STORMS fEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn to ClUb Septic Tanks From Main to Curb
hom ClUb to Building Electric Pumps From ClUb to BuüCÜDg
Repair
INSIDE WORK
110. NEW ..,. USED FlES NO. NEW REP. ~ fEES NO. NEW REP. USED fEES
Bath Tub Garbage Dispooals Catcb BulDs
f------ - -
Wuh Buin Dishwuhen - Conductors
- - - -
Water CIOl8t LaundramaIR Greue Catch BulDs
-
Sink Water Softeners Sump Pump" Ejectors
Water Heaters I It-d Sanitary Bubblers Bar and Soda Wastes
Shower IIatha Urinals I
Floor Dr"'" Dental Cuspidors 1-
- -
Laundry Tubo Service Sinks
IlIIpactionR Valuation of the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Feet
---------------------------------.----------OuÞide $--~_P_Q--,----~--- -------------------.------------ ---------------------------Sewer F-
---------------------------------------------------.-Inside -----I---~---.-plbg. Fees
--------------------------------------------.------- $------.----------------------.---.-.-------------------------------------- -----.I<--.~----Total
---------------.--------Flnal OK $------------------------------------------------------------------- ---------------------------Eriÿ-T,è;;-~;;;;----------------------_.- Date 'Ý-3' 76
In the perform. nee of this work the undersigned owner (or hi. authori.ed agent) of .aid premi.e. and his authorized Plumber hereby agree to be bounden by and
submit to all statute., city ordinances. and rules and regulations prescribed by the B...rd of Public Works for the government of Plumbers.
It Is luther agreed by the undersigned that no other uses will b. made 01 the above connections except as hereinafter listed.
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