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Mar041311:37a Preferred Plum I ing, Inc. 952-447-5764 p,3
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<br /> FI TURE BSMT 1 2 O�I'HER FIXTURE BSMT I 2 OTHER
<br /> � PL FL ' TYPE FL PL
<br /> W ier Closet ,� Floor Drains
<br /> La atory 2 Sewer Ejector
<br /> Ba tub ,� Laundry Tcay
<br /> Shpwer �� Washer
<br /> Kitchen Sin.k � Water�Ieater
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<br /> Di�posal ' ,� ~ water Softener '
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<br /> Dishwasher ,� Wet Bar
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<br /> [] Yes,this section applies � �
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<br /> Thc replacement of only nc I�iesidential frxture or anpliance that meets all three of the fo(lowin�
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<br /> requirsmen : .., _._____ ._ _.�._ __ __ , _ _
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<br /> _ _l. . Does not c uire:modiftcation to electrical or gas service. . -.- __.; ._ .. . ---. __;
<br /> '•� 2. Has a totai ost Qf�500.00 or less;excludme the coSCof the fixture or appliance:and
<br /> 3._ .[s imp�ove inst�alled or replaced by fihe.6omeowner or ticensed plumbing cc�ntracto�_ __
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<br /> Skip next s ction,�f this applies; Cost of Pe�mit $ 1 SAO
<br /> , y __ .Statia Sui�char�e $ 5.00 -
<br /> Mail-In Fee(IfApplicable) __ $ 2.00 _._
<br /> _._ _ . _.___ _ _ _
<br /> Total Permit Fee S
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<br /> (Permit Fees Continue On�1ext Page)
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