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01/04/1 99 0:25 6128663059 SOUTHTOWN PLUMBING PAGE 02 <br /> F <br /> ✓ <br /> ��/1��i7A{,���J�S.��/{�,� 1 <br /> �:ILI S F <br /> 'FI URE BSMT I 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TY FL FL TYPE FL FL <br /> V1/ Claset � Floor Drains <br /> La ry .� Sewer Ejector <br /> at b Laundry Tray <br /> ho � Wacher <br /> itc Sink Water Heater ' <br /> qi Water Softener <br /> s sher Wd Bar <br /> Si Ic s " <br /> Miscellaneous <br /> . '.•1 v ALC ATC� "'�_� °." , � ,' ,.,,.,•„ <br /> :,�. <br /> ^ �y�yi,.:,, , �.,�.. ��y7{�y1�ti��,. . <br /> � .. ',�f•: ..1�•.� , '�t.,� `fii1;'.r�' :Y .► � <br /> CS.d11S SCCtlotl B�IICS ' <br /> T e�epi ont of only one Besidenciel fixeure or ano1��that maets a��cbro�of the following <br /> ' uir ts: <br /> pas not roquire modificalon to electrical or gas service. ' <br /> H�o�of SS00.00 or less;oxcludine du cost ofthe fixture or epplianoe:and <br /> Is improved.insWled or raplaced by the homeowner or licensed plumbing conaactor.' <br /> Skip next soetion,if this applies; Cost of Pecmit a 15•00 <br /> Stace Surcharge S 5.00 <br /> Mail-lnFee(1fApplicable) S 2.00 <br /> , TotAI Permlt Fee s <br /> (Pe k F s Contlnuod On Next Pa�e) <br /> 2 <br />