HomeMy WebLinkAbout0009017-Plumbing
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I Lot No.
r:: I Ward
I Addition or Replat
Dale
OUTSIDE WORK
NEW SEWn WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn to C1I1'b Seplic Tanks From Main to Curb
f\rom C1I1'b to BuDding Electric Pumps From C1I1'b to Building
Repair
INSIDE WORK
NO. NEW UP. USID FlES NO. NEW REP. USED FEES NO. NEW REP. USED FEES
~ - -
BathTub Garbage DIR~ Calch BaslBs
- -
Wuh Basin Dishwashers Conductors
- - J,ð(} - -
Waler CI_t LaundramaIR / Gre... Catch Basins
/ -
SIDk Water Softeners Sump Pump 8< Ejeclors !,Ò
Water Heaten Sanitary Bubblers Bar and Soda Wastes
Shower Balha UrinalR
Floor Drains / /,O( Dental Cuspidors
Laundry Tubs j j,Otj Service Sinks
Inspections V#lion of the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Fees
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$ 0000 mm" ... 00... m.....nnmnmm_.mnm' --..m --00__.00 m - :;¡f~.4._f2mn___Plhg. Fees
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In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by ond
submit to all statutas, city ordinances, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be made of the above connections except as hereinafter listed.
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STATE OF WISCONSIN)
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¡Name!
WINNEBAGQ COUNTY
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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 n9 Inspector of the City of Oshkosh, to do
plumbing work in a :'orne owned and oooupied by him, or a home
that is being constructed that is owned by hi~, and which will
be occupied by him", his home when completed. That he is not
building said home for the purpose of sale.
This affidavit ~s made for the purpose of çomplying with
the provisions of the plumbing code of the City of Oshkosh and
the State of Wisconsin, which provides that all plumþing work
must be done by a licensed plumber except that the plumbing work
may be done by one ~ho owns and oocupieshis own home providing
the installation coæplies with the plumÞing code of the City of
Oshkosh and the State of W~consin.
This affi3nt undentands that the Plumbing work authorized
by the permit applied for, must þe done only by this affiant and
that he oannot emplov others who are not licensed plumbers to
assist with the work.
D,t,d thi' ---'- d, Y of ~y~
Subscribed and sworn to before me
this ~'..,.;:;.. .y Of~- ._, 19~J.6.
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Notory ie- Wi",: '~'Ücon'in
My Commission Exoires: fcl-023-?9
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