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06��9/2415 TUE 8: 53 FAx 763 a73 8565 Sabre Heating b air Cond f�006/007 <br /> r <br /> �'IXTUR� BSMT 1 2 OTT�ER, �IXTURE SSNiT l 2 OTHER <br /> TYPE FL I'L TYPE FL FL <br /> Water Closet ` � Floor brains l <br /> l <br /> I,avatory Sewer Ejector <br /> � � <br /> Batlttub � � Laundry TrAy 1 <br /> t <br /> Shower � Washer <br /> � <br /> Kitohen Sink l 1xlator T��tter <br /> Dispo�al , W�ter Softener <br /> Dishwasher � Wet Har ' <br /> Sillcocks � Miscellaneous <br /> Il F �/ <br /> f <br /> i �'� . <br /> I� ❑ Yes,this section applie9 . 1 <br /> � Tt�e replacemenl of only one Residential�xture or ao�ligncg th�t meets all thrae of the fallawing <br /> requirements: <br /> J. AS7g,�not require modification to alectrical or gas sorvic�. <br /> 2. l�as a total cost of$SOO.OQ o�less;�xcludincc tha cost of tho fixture or appliance:and <br /> 3. ls impro�ved,installed or roplacod hy the hameowner or licensed plumbing contractor. <br /> Skip next sect�on,if tlus applies; Cost of Yermit $ 15.40 <br /> State Surcharge � 5.00 <br /> Mail-i��Fee(If Applicabla) � 2.OQ <br /> 7'otal Permit Fee $ <br /> (Permit P'eee Co��tinued On Ne�t Pnge) <br /> 2 <br /> I <br />