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05/22/2014 11:2� FAX �5293a5049 CtiLLIGAN MNTKA C�003 <br /> �� . <br /> - �Lu�r�G.��i�rx�s;�BE�r��.�rs��c;L��� � �.,� <br /> -���,.�� <br /> FIXTL'RE BSMT 1' 2' OTHER FIXTL'RE BSMT 1 2 OTH,�R <br /> TYPE PL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> LavAtory Sewer Ejector <br /> Saehtub Laundry Tray <br /> Showcr Washer <br /> Kitohen Sink Water 1-fealer <br /> Disposal Water Soflcner <br /> �ishwasher Wct Bar <br /> Sillcocks Misccllaneous <br /> ,oZ�y�!dr�,a k'��71,Gai�p�r7!��Gk*emi Y,Pa� r`ry}(i� y�,7�1�-ry ti l� <br /> f �q �„�Y.��t3 ✓.��i { � { �1�i�41Y��':1;�1'iP�.�" J � �� ,,�+ I ��U1���E���i�"�`'Palbi�7�j��l�M�r�la h�b."^'�'� <br /> , �i i'p y J n �li 7 I e S � i <br /> �,�S,f a{�'����6q��p��N�'����r'i 14�A�J b I,� i � i ��. u a � � ��� �, � ���pX h�,�r,Ir i+r q i��i�F,1�r� t �. W �a�4.J�� <br /> �dl'���,��)h��ld IGTr�I+Wh�lf���r i�a,�'f! �yry�It r Pi�,�� �V � v � � , � � �i �j�� Ce�llll�l���A^I"��4r 1��d°�M R <br /> $P:5`ETJ C7�'�' �OC�2,�`�,A,�'�5�'�TC7� .�.:����.��tr:R��",.i�-�����•�� <br /> ❑ �'es,this section applies <br /> The replacement of a R Idtntial fixture or a liance that meets all three of the following requirements: <br /> 1. Does �ot rcquire modi'Ecation to e]ectrical or gas service. <br /> 2. Has a to I cost of$500.00 or less;excludin�the cost ofthe'Gxture or appliance; and <br /> 3. Is improved,installed or replacod by the homeowner or lieensed contr�actor. <br /> Skip next section,if this applies; Cost of Permit $ ]5.00 <br /> State Surchargt � 5_00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fec $ <br /> (Pcrmff Fees Continued On Next Page) <br /> � <br /> I <br />