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01/16/2008 16:01 7637534514 LIBERTY PLUMBING & H PAGE 03 <br /> 4 r <br /> nl'i{::�: �_� - fi1�.P if er}L•� ��"w,:) '�/��;\'��• �?r4.V•� r11F JY��r�:: i,. •t:•P' :w�a•:'•::.r..' <br /> F1XT'URE I BSMT 1' 2N11OTHER FIXTURE. BSMT I�12 NIJ OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet I Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathmsaa I Laundry Tray <br /> Shower WaSIWL <br /> Kitchen Sink Water Heater I <br /> Disposal Water Softener <br /> Dishwasher Wet Har <br /> Sil lcocks Miscellancoue <br /> • ,r <br /> •�nii.n.k <br /> .�n�::..•r..n�.n..�.•nd��I.�..ir�,..�A.r.1tI.:.', �.�..•�..•nro.,...�r,.nry•,�n i.�.I,,I..'�,14.:. r.....,...... �:.i•I.A.4I:;•pr�:•,n.•.d.r.T.: <br /> n.i,:•i...��,..�.:e••:ni.i�..:.,,'d...i;...�..'�,.;..� �.��..... �aryI,Y Iri•.i•�..4j,.3•�.... <br /> •r•'Y': <br /> // <br /> '.•!'..�• <br /> .r�'. �.l''�.• •i'l <br /> iii l.1�,.�.1�,:::•` to ' <br /> 1. <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture orsap II.D aRCe that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> Z_ Has a total cost of$500.00 or less;excluding the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section.if this applies, COST.of Permit $_15,00 <br /> State Surcharge $ .50 <br /> Mail-in Fee(If Applicable) $ 1.50 <br /> Total Permit FP.P. S <br /> (Permit Fees Continued On Next Page) <br /> . 2 <br />