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To: Page 3 of 5 2015-01-16 22:02:13(GMT) 17634452061 From: Mark Conner <br /> � . <br /> PLUMBI:�IG F1X'[1JR�513�iN(.; t�lS"1'A.i.LEI� � <br /> FIXTURL BSA�E1' � 1''T ,"`� OTFII?R PIXTURr BSMT IS� 2ND ? OTHE� <br /> TYPE ' FL PL TYPE FL h'i. <br /> __ � <br /> � Watcr Goset � I�loor Drains <br /> � <br /> Lavatory i Scwcr�jcctor � <br /> —_. <br /> BathhGb Laundry Tra}� <br /> ` <br /> S'eower I �Vasher I <br /> , <br /> � ' --_ _ - - <br /> � Kitchen Sink � �t'atcr Hcatar +� <br /> c� <br /> Dis�osal VJatcr Softcncr � <br /> Disl�washer W et 13ar <br /> Siilcocics Miscellaneous <br /> i i <br /> _ --- ------- - -- -- — <br /> (TT PER�11I�I�'L:E C;�'11;C��I.�Ti�'�{S) <br /> i BASEL? OI�P -2C{)2 SlI��Tf: STf�.I_Ui: <br /> ❑ Yes,�lus secrion applies <br /> The replaceinent of only one Kesictential fixture or ap lip ance tliat meets a11 threE of d�e following <br /> requiremcnts: <br /> 1. Does not require modification to electrical rn•gas service. <br /> 2. Has a folal eost of JSU0.00 or less;excludin�the cost of tl�e fixture or appliance_azid <br /> 3. Is improved,installed or teplaced by the homeowner or liceiised plumbiag cantractor. <br /> Skip next seciion,if this applies; Cost of Permit � 1�.00 <br /> State Surcl�arge � 5.0� <br /> Mail-Tn Fee(If App(icable) $ 2A0 <br /> TotaP Perznit Fee $ <br /> (P�rmit Fees Continued On Next Page) <br /> � <br />