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. Fro�:6&D PLUMBING 7634974263 01 /06/2014 11 :36 #133 P.003/004 <br /> FIXTUft� BSMT 1 2 OTHER FIXTURE B5MT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Baflitub Laundry��rp- ` <br /> ��t\� � <br /> Shawer Waslier <br /> Kitche,.n gink � Water Heater <br /> Disposal ' Water Softener ; <br /> Dishwasher } Wet Bar <br /> Sillcocks Miscellaneous � <br /> ���.(,J1�Y�;�.C.�R� <br /> �O�S �1��5 �ti <br /> ��21.4"���-� � G�,1���. <br /> � � �.. PERMIT FEE��LCU�.ATIC7N�S) ��.� <br /> _w _�.�. �_ � =�3���D c7F� Z�(l2 ST�T�S'�,�'I'U� - .�, _,_...__ _:� <br /> ❑ Yes,this section applies <br /> Tlie replacement of only one Residential fixhu�e or appliance that meets all three of the following <br /> requiremeat�: <br /> 1. oes not require mo�cation to elechical or gas seivice. <br /> 2. Has a total cost of$500.00 or less;exciudinct the cost of the fixriu�e or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or lioensed plwnbing contractor. <br /> Skip next section,if this applies; Coat of Pennit $ I S AO <br /> State Swcharge $ 5.00 <br /> Mai]-In�'ee(If Applicabie) � 2.00 <br /> Total Per�u[t Fee S <br /> (Permit Fees Continued On Neat Pxge) <br /> 2 <br />