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From:7634974263 02/06/2015 08:25 #Sl8 P.003/004 <br /> � �2/05/2015 15:13 9522494616 CITV pF OROND PAGE 03/06 <br /> 1 1.'�+L✓��,Y�I�`' l�'� �, i:: � EI.'l./.;iRYM l�;. .�(�i.'.'. <br /> ��. <br /> PIXTURE BSMT' 1 2 OTHER �IX'�URE BSMT I' 2 OTHER <br /> T�'P� FL FL TYP� PL FL <br /> Water Ci4set Floor Drains <br /> L�vatory Sewer Ejectar <br /> Bathtub Laundry Tray <br /> Shower VJasher <br /> Kitchcn Sink + WabEr Neater <br /> Aisposal � Water Softensr <br /> Dishwashcr � Wet Bar <br /> � <br /> Sillcocks Miscellaneous <br /> F�-t����i W.tit�. � <br /> i �n e�. <br /> Y.`;•h °(�t>• �rM'��w 6 y T� A� y v , ,t+ ; � _. .. .�.afi�w a i� 3e,1 ��r� �U��.y�,: . . <br /> `�� � a�1b ° ��,� �N'��+� ��!y y� ,C�r uya ��(��. `4++b,��,�c �i (,i,q�� �, <br /> „� ' . �.�'�n ��; Y���.,rii��iY� Y "421.1 , .V�r.r �J�� . `�1,C'r�'�4T�µ .�7���W=-���)����! <br /> �l <br /> ❑ 'Yes,this section applies <br /> The replacement af only one Residentia]fixtwe or_aDaliance that mee��ai.l three of i�e following <br /> rcquircments: <br /> ]. boes not require modificacion to cicctrical or gas sorvice. <br /> 2. Nas a t cost of.5500.00 or less;e ud' the cost of the fixture ar appliance:and <br /> 3. zs improved,instFallad or replaced by tbe homeowner or iicensed plumb�g contractor. <br /> Skip next section,ifNus appties; Cqst oFPetlnit $ 15,00 <br /> State Surcharge $ 5.00 <br /> Mai3-In Fee{If Applicablc) $ 2.00 <br /> Total Permifi Fee $____ __ <br /> i <br /> (Perznit Fees Coet►nued On Next Page) <br /> ;=; <br /> 2 <br /> �' <br /> �; <br /> � <br /> ;�:' <br /> _.._.. . I :' <br />