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05/12/2014 69:39 7632592299 SCHULTIES PLUMBING PAGE 65/09 <br /> FTXT'URE BSMT 1. 2 OTHER FIXT[3RE BSMT 1, 2 OTHER <br /> TYPE FL FL TXPE FL FL <br /> Water CEoset � Floor Urains I <br /> Lavatory 1 Scwcr Ejextar <br /> B��h Laundry Tray <br /> Shower ��� <br /> Kitchen Sink Water Heatcr � <br /> Disposa[ Water Softener <br /> Dishwasher Wet�ar f <br /> t <br /> Sillcocks MiSCeI Ikneous <br /> o� <br /> ❑ YCS,this sectian applies <br /> The replaccment of anly one Residential re or liar�ce that meets all thrce of thc followi�g <br /> requirem,e�►ts: <br /> 1. Daes not require modification to electrieal or gas service. <br /> 2_ Has a total cost of$S00.00 or less;excla ' the cost of the fixture or applianec:and <br /> 3. Ts improved,installed or rep�accd by t�e home�wner or Ircensed plumbin.g contractor. <br /> 5kip next scction,if this applies; Cast of�ermit � 15.00 <br /> Statc Surcharge $�p <br /> Maif-InFcc¢fApplicable) $ 2Q,� <br /> Total Perrnit Fee $ <br /> (Permit Fees Contlaucd On�Neat Page) <br /> 2 <br />