Laserfiche WebLink
06/30/241a MOx 12: 52 Fax 555 5555 Sabse Heating � Air Cond f�003/007 <br /> , <br /> FTXT'URE �sMr i z o�R �z�� Bsna-r r 2 o�a <br /> 'r'ypg FL FL TYPE FL FT, <br /> Water Closet � � Floor Draias I <br /> Lavatory � Sawer�ijector <br /> Aathtub I L&u��dry nay � <br /> Showar • 1 Washer � <br /> t <br /> Kitch�Sink , Water Heatar � <br /> Dieposal , WAter Softemer <br /> blshwa9h�r 1 Wet�ar <br /> 9illcocks � Miscellaneous <br /> i , <br /> �. <br /> Q Yes, th�s section applies <br /> 'I'he replacement of only qne ResidentiAl_fixh�re o�avnliance that meet9 all three of t.he followiilg <br /> requirements: <br /> 1. Does not require modificxtian to eleotrical or gas sarvice. <br /> 2. Has a t 1 cos of$500.00 or lese;g�j��the cost of the fixtur�or applisnce; a�id <br /> 3, Is improved,installed or replaced by the hameowner or lice��sed plumbing contractor, <br /> Skip next soction, if this a�plias; Cost oEpermit $ 15.00 <br /> State SurChaYge $_ 5.00 <br /> Nlail-In�ee(If Applicable) � 2.OQ <br /> Total pe,�mlt Fee $ <br /> (Permit Fee.v Continued On Next Ptt�e) <br /> 2 <br />