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1 FJML 143237 <br /> I <br /> i <br /> � <br /> TXTCIR� B�MT E 2 OTHER FIXTURE BSMT 1 2 OTtiER: <br /> PE Fl. �'L. TYFE Fl: FG <br /> Watcr Ctoset Floor Drains <br /> LavatorY Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> ICitchen Sink Water Heater <br /> Disposal Water SaBener <br /> Dis}�washer � Wct Bar <br /> Sillcocks Misccltaneous <br /> � <br /> ❑ 1'e�,this sa�tian�Pplies <br /> The replaccment of only�ne Itesidential fixtuce or annliffisee that mcets�1t�of the following <br /> requirements: <br /> 1. �ggg„�,Q�rsquire rnodification tn el�lrical or gss service. <br /> 2. Has a��cost of��OO.QO or less;�cludina the cost of the fi�ure ar app(iance;and <br /> 3. ts improved;installcd or repl�eed by th�c horneowner or licen�ed plWmbin�contrsct�t. <br /> Ski�next sectian,if th9s a}splies, Cost of Narmit $ 15.00 <br /> �I State Sutchazge � <br /> s.oa <br /> Maii-fn Fee(If Applicable) S Z.QQ <br /> Total Permit Fee 5�2.00 <br /> II <br /> i <br /> (Permi#Fees Contin�ed Qn 1"+le�rt PAgej <br /> I <br /> 2 <br />