HomeMy WebLinkAbout0009670-Plumbing (fixtures)
I'
[
.-.
ì
/
~~~-4,P:~~Q;~~~ ~Q~"&l"L1:"*.
I Lot No. I Block I Ward ___1 Addition or Repl&!
OUTSIDE WORK
Date
NEW SEW" WATER STORMS FEES FE" RELAY S. SEWER WATER STORMS FE"
From MaIn to Curb Septic Tanks From Main to Curb
FJom Curb to BuDding Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
USID
NEW
FE"
NEW
FE..
REP.
USID
fI..
NO.
REP. I USED
"0.
REP.
Batb Tub
/
/
/
/
/
Sanitary Bubblers
Bar and Soda Wastes
Garbage Dlapcoals
CIIich Basins
Dishwashers
-
Conductors
Wash Basin
/
¿rtf
Grease Calch Basins
Laund>amatJI
WatN CI_t
~
Sink
Waler Softeners
Sump Pump 8< Ejectors
/
Water Heaters
Sho..... Baths
Urina1a
Floor DralDo
I
I/. AI
Dental Cuspidors
Laundry Tub8
IDlpeciIona -
----"7-Z-- -õ-/----}'"--.-.-.----___---OuiBide
-------U? -__1-i-2.JL____.__.._------____Inside
Seni.., Sinks
Fee Verified. Receipted and Recorded
Received Permit and Inspaellon Foes
-----::_~2f~~~r F:7
Valuation of the ~ Herein Described
$-ðllf2Û_'__--------------------------------_._----
~
----
----'-"'C-;¡:¡T;;;;~;;;-"--"------------------
Dale
// F 7?>
---------------------FiDal OK
$--.-------------------.-.-.------------------------------------
In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorired Plumber hereby agrea to ba bounden by and
submit to all statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works lor the government 01 Plumbers.
It Is luther agreed by the undersigned that no other uses will be made 01 the above connections ex:cept as herein"'er listed.
_....----------.--..
--,---~~-
Plumb.,
--'--------:~~::L~~;~:.:_:_..:.:_:_:__:_-_::_:_---_....------