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06i2a/2015 14:09 FA?i 95293a5049 CtiLLIGAN 17NTRA �J003
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<br /> � HER FIXTURE SSMT 1 � 2 �� OTHER
<br /> �'IXTURE BSAQT 1 � OT
<br /> "TYPE FL PL TYPE FL FL
<br /> Water Closct Floor Drains
<br /> Lavatory Sewer Ejeccor
<br /> i 1
<br /> Batl,tuB Laundry Tray i
<br /> i
<br /> Shpwer W ashcr
<br /> Kitchen Sink 'Water Heater
<br /> Disposal Waier Softener 1
<br /> Aish.vasher � Wet Bar ;
<br /> SiIICOCI:s Nilscellaneous '
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<br /> �a-�;�,,', R�� +��,; ,.. �� ��,�,` B�1SED C�}k'�'-�.��1'? �'T'�4"f�S��1TUE �i' '� ' i � '`,,�� �.�„
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<br /> Q 1'es,this section applies
<br /> The replaccmcnt of d Resident'ial fixture or aDA���ce that mects all thrcc of the Collowing requlrements:
<br /> 1. Does not require modification to electrieal or gas service.
<br /> 2. Has a total cast of$500_0o or]ess;cxe3udin�the cost of the fi�ture or appliance: and
<br /> 3. rs improved,installed or rcplacod by the homeowi�e�or licensed contractor.
<br /> Skip next section,if this applies; Cost of Permit $ 15.00
<br /> Stat�Surcharge $ 5.00
<br /> Mail-In Fee(If Applicablc) � 2.00
<br /> Tatal Permit Fee $
<br /> (Pcrmit Fees Continued On Next PAge)
<br /> 2
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