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05/06/2014 TUE 12: 29 FAX 763 473 8565 Sabre Plumbing & Heating 8003/007 <br /> <S`.T'1 e t, � d l�l.� .aeossa�y,.•es �vs� ,a�.v x+�4-'� x^ ese� .*+�ys' sec.q '^'E{K`sF�.<:�..�, <br /> r . .� t `u h: e�. ev IT ash, ?:fie ° aIC �,, ` .h.i _f i <br /> k_.r�., _...,.�..a,,... ,.._...��s;1 .-�.,� �.d,,.,`��'����b.r.4.���,.�L„��'M�.s,..��a r���..�.�i�.��:n b,�'x�v:,�d���.,�vd�.....,'� �..�:c.:�i�.�wu <br /> FIXTURE I3SMT I sr- 2ND OTHER FIXTURE BSMT l ST 21QD OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet LA <br /> Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Z 1 <br /> Washer 1 ` <br /> Kitchen Sink Water Heater <br /> Disposal ` Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> 0 Yes,this section applies <br /> The replacement of only one Residential fixture or appliance that meets all three of the following <br /> requirements: <br /> I. Does not require modification to electrical or gas service. <br /> 2. 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 plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />