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:0/19/2417 THU 15: 29 FF►x 763 a73 8565 Sabre Hedting 6 Air Cond �403/007 <br /> r+1X7'CJRI± BSM'T ! 2 OTl�R 17I�GTUR13 RSMT 1 2 ()TfiFil.t <br /> 'r"Y�E FL �L TYPF r1, n1, <br /> Water Cioset � � �loor Drains �W�~ � <br /> �' <br /> I.avntory 1 � 5ewer Ejector <br /> 1 <br /> Bathtub � Lau�id�y Tray I <br /> Shower ` Washer <br /> Kitchen Sipk 1 Water Heater � �.. .. "�.� <br /> 1)iSpo5a1 ' WAier$OftenBr+ � <br /> Dishwasher ' � Wet Bar <br /> Sillcock� � 1Viisccllaneous <br /> ❑ Yeg,this section applies <br /> The replacemcnt of anly one Residentiai�xtura or apnliAnc.�tha#mcets all xhree of the foilowing <br /> requirements: <br /> l. Doos not roquire modification to olaci,ticfl.l or gas se�vice, <br /> Z. Has a total c�rt of$500.00 or les&;exclud9n►the cost oE t3�e f xture or appliancs:and <br /> 3. Ts improved,installect or replaced try the homeownor or licansed plumbing co�ntractor. <br /> Skip nsxt section,if t6is applies; Cosc of�ermit $ 15.00 <br /> State Surcharge $ 5.00 <br /> N�ail-L�Fee(If Applicabte) �,�,2�0 <br /> Tou�l permit Fce S <br /> (Pernnit Feca Corttuiucd Oa Nea�t�age} <br /> I <br /> I 2 <br /> I <br /> � ' <br />