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10/la/2014 13:2a FA� �5293a504� CULLIGAN MNTKA C�003 <br /> � <br /> �.�.' 'Px.Y7'MB1NG�'Z�I'T�RE'S;BEINGra7�rST�:L;LED' <br /> FIXTUIZE BSMT 1 2 OTHER FIX'1'liR� BSMT 1' 2 OTHER <br /> TYP� FL FL TYPE FL FL <br /> Woler Closet Floor Drains <br /> Lav�tory 5ewer�jector <br /> Bathtub Laundry Tray <br /> Sl�ower Washer <br /> ICitChen 5in}: Water I�eater <br /> Disposal Water Softener <br /> Dishwasher W�g� ' <br /> Sillcocks Miscellaneous <br /> i <br /> � �,rh n)r�rq ��r p {���,��,� y.� �+ <br /> �,'�t�i�j Rp ���Ila���� y � �l � � ���r y � .vrG i fhi i ,�� ,��� �i � { <br /> �A�Ty' C� <br /> �}��0��`��I 9.,�(M � n��a h�� �� � '�r n ). �,���t�1 A����7� Y� 4 i .�$1�ti i��l ;��°�����i��Pi� �Pr4� <br /> �y �7 [� F <br /> � , k C �1 i � rl"1 ���,,, ��u-. . . , ��i it�i t � I� ' <br /> ,�,q��, ,-��F� <br /> ! ,,� P}� 1kd.�1�� trn�h,�.i�.4, a��.Y'11D�L'�����. �VQ��,���.1'�L' J�A.��. _.��4M��1� 9�,n G Yi�,p��i"Pq���l���'�'�p��l <br /> �'n,�YI,.. rd�.;�,.��I 1;Glrcl't . <br /> ❑ 'Yes,this section applies <br /> 1'he replacement of a Re identia]fi re or a nliance that meets aIl thrce of the following requiremen�S: <br /> 1. Docs not require modification to elechical or gas service. <br /> 2. l�las a total cost of$500,00 or less;e cludin the cost of the fixture or appliance:and <br /> 3. Is improvcd,instAlltd or replaeed by the homeowncr or licenscd contractor. <br /> Skip next section,if this applics; Cost of Permit $ 15.00 <br /> State Surchar�e $ 5.00 <br /> Mail-In Fee(If Applicable) $ ,2.Q0 <br /> Total�'crmit Fee g <br /> (Permit Fecs Continued On Nezt Page) <br /> 2 <br /> � <br />