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06/22/ZO10 14:07 FAX 9529335049 CULLIGAN MNTKA l�003
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<br /> FIXTURE BSMT 1 2 OTHER FTXTURE BSMT 1 2 OTHER
<br /> TYPE FL FL TYPE FL FL
<br /> Water Closet Floor Drains
<br /> Lavatory 5ewer Ejector
<br /> Bathroom Laundry Tray
<br /> Shower Washer
<br /> Kitchen Sink Water Heater
<br /> Disposal Water Softener �
<br /> Dishwasher Wet Bar
<br /> Sillcocks Miscellaneous
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<br /> €b�a������ ���° �3,;;� {.,�f ,,., .,��� �,,', BAS�ED,QFi�, 2002'Si'A`�� S�:AT�E���� �� �� �,�t� , , �,.
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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 requirements;
<br /> 1. Does not require modification to etectrical or gas service,
<br /> 2. Has a total cost of$500.00 or less;exctudinQ the cost of the fixture or applia��ce: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 $ .50
<br /> Mail-In Fee(If Applicable) $ 1.50
<br /> Total Petmit Fee $
<br /> (Permit Fees Continued On Next Page)
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