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e5/19/2014 14: 13 9529127394 CULLIGAN HR PAGE 03/04 <br /> , ; . , , 1�I;�t�I�TB1N'C��'T�'MJ�'���E��7'�INS�',1��;�;�.1� <br /> rIXTURE BSM� I 2 QTl-CER FIXTURE BSMT t' 2 OTHF,R <br /> 7'YPE FL Fl. TYPB �L FL <br /> WRter Closet Floor p�rsins <br /> Lavatory SCwer�jeCtor <br /> Bathtub Lal.mdry Tray <br /> Shqwei Washer <br /> };itchen Sir1k Water Hcater <br /> Uisposal Water Softtner <br /> Dishwttsher Wct Bar � <br /> Sillcvcks Misccllaneous <br /> 1�2�n'�r��I�i��a�i��! �1i��I 1�II A� Mr�f,l 1 i �i !�i g� ,. <br /> `I'����l � ��',.� �,,� � ��R:;�cr��G�At:,�' ,, r ,, ,,'�� � � � c�� <br /> v i ,i; I I Y .rI�! y � 1 I i i t <br /> i i ������ ���� � !1 a,�y i �+7� c�l. � 1,���� 1 x ,a �h, �l i `4�i�a !,d <br /> ������,1{�"� ��i�l�vr�'`i�i;�:,� 'td� �'i 'i� i� ��,;'.[���1"i1.,1�'`{ j��y �` }(.�y� �ry ry�'� "t�'y ����� ���i f�,i r�,—"illi `"'y���r�; <br /> �f i F�. ,I � �J��I'��V.✓J��O�l't 1.�" �7��':L��U� � � �t .i;��j�il 1;,,�'1� i I� t����l.l��l <br /> y `� �r� ��rl��;,.�. <br /> � Yes,tE,is secl'ion applits <br /> 7'he repiacemcnt of a Resid,gr�i;iR!fxture or appliancc that mects all thrcc of 2he following requirements� <br /> t. Does eot require mndi,ficption to eleCtrical oC gAs serviCC. <br /> 2. I-Ias a totn cost of$500.00 or]ess;e c udin the cost of the fixture�r appfiancc:and <br /> 3, Is improvcd,instal[ed or rcplaced by the laomeawner or]icenscd�ontractor. <br /> Skip nexz section,,ifthis applies; Cost of Permit $ 15.00 <br /> State Surcharge g 5 00 <br /> Ma.il-In Fee(IrAppliaable) $� 2.Oq <br /> Total Permit�'ee $ <br /> (Pcrmit Fccs ContSnued On Next Page) <br /> 2 <br />