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_ 05/06/2010 12:10 FAX 9529335049 CULLIGAN MNTKA C�003
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<br /> FI3CTURE BSMT 1 2" OTHER FIXTURE BSMT 1 2 01'HER
<br /> TYPE FL PL TYPE FL FL
<br /> Water Closet � Floor Drains
<br /> Lavatory Sewer Ejector
<br /> Bathroom Laundry Tray
<br /> Shower Washer
<br /> Kitchen Sink Water Heater
<br /> Disposal Water Softener I
<br /> Dishwasher Wet Bar
<br /> Sillcocks Miscellaneous
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<br /> Yes,this section applies
<br /> The replacement of a Residential fixture or appliance that meets all three of the following reqairements:
<br /> 1. Does no tequire modification to electrical or gas service.
<br /> 2. Has a total cost of$500.00 or less; excludinQ 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 $ .SO
<br /> Maii-In Fee(If Applicable) $ 1.50
<br /> Total Permit Fee $
<br /> (Permit Fees Continued On Next Page)
<br /> 2
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