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93/20/2096 14:26 6513651332 HPPIPEWORKS PAGE 02 <br /> ' � I � <br /> FIXTURE BSMT 1 2 OTHER FiX7URE BSMT 1 2 OT�I�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains ' <br /> Lavatory 3ower Ejector <br /> Bathroom Laundry Tray <br /> Showcr Wagher <br /> Kitchen Sink Water Heater � <br /> Aisposal Water Softener <br /> Aishwasher Wct Ber <br /> Sillcocks Miscellaneous <br /> ; � ' ; 1 ' <br /> � <br /> , , <br /> � � , . <br /> � Yes,this sectian applies <br /> The replacem�t o£a�esidential fixture or qpp]iance that mcets all throc of thc following requirements: <br /> 1. ocs no rcquirc modification to elecirical or gas service. <br /> 2. I�as a coat of 3500.00 or less;gxaluditig tho cost ofthc fixtvrc or appliancc:and <br /> 3. [s imprwed,installed or replaccd by the homeowner or licensed contractor. <br /> Skip nacc scction,if this applics; Cosc of Permit S 15.00 <br /> State Surohacgc $ .50 <br /> Mail-�n Fee(af Applicable) a 1.50 <br /> ' Toml�crmit Fcc �i .00 <br /> (�crenit�'coe Continu�ed On Ncxt Page) <br /> 2 <br />