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APR-5-2010 02:07P FROM:JOHN MYERS PLUMBING 6514397764 T0:9522494616 P. 1�1 <br /> AI�UM�TNG F'[�7'URES D�T1�fG 1:1�1�aTA'I,[,�1� > <br /> FIXTURG BSMT 1 2 OTHER FIXTURE BSMT I 2 OTFIER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � � Floor Drains <br /> Lavatory � � Sewer Ejector <br /> Bathtub � Laundry Tray <br /> Shower � Washer <br /> Kitchen Sink 2 Wa[er Heater � <br /> Disposal � Water Softener <br /> Dishwasher � Wet Bar � <br /> Sillcocks Miscella�ieous <br /> 1�f�RM�T FTC CAL;CUI.ATI�.1N(�) <br /> ' AAS�A OFF-2;002 �aTATG ST'AT�1� <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> I. Does not require modification to electrical or gas service. <br /> 2. Has a ota cos of$500,00 or less;excludine the cost of the fixture or appliance:and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contraetor. <br /> Skip next section,if this applies: Cost of Permit $ 15.00 <br /> State Surcharge $ .SO <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> TotAI Permlt Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />