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06/28/20a0 02 :34 FAx 7634775629 C�0031005 <br /> � •--- �-- ._�. <br /> G7,'W'�`!",°q„S' <br /> a�P, ' �yi,:'�,'itt <br /> FlXTURE BSMT 1 2 pTHER FiXTURE <br /> TYPE FL FL .fYPE gSMT <br /> ! Z �TlNER <br /> Water Closet FL FL <br /> Floor Drains <br /> I,avatory <br /> Sewer L�joctor <br /> Bathtub <br /> Laundry Tray <br /> Shower <br /> Washer <br /> Kitchcn Sin� <br /> Wator Heater <br /> Disposa) <br /> Water Softener <br /> Dishwasher <br /> Wot Bar <br /> Sillcocks <br /> Miscellaneous <br /> ,i J ���'ya,7�� a,i a; f s,y' .y k <br /> W„ '�-i i'"Y' ���'L Y' „T� „,�,�1'" ^' ` { �-�`--T <br /> +.�,�1t� o'�'.G.YJ � � ')1 f�"�Al �';�7�t����"i�. ��+���,� , � i v�^ K.,�,�. � � <br /> ! <br /> �.{ � ,,y ��7 1. i �) 1' , r'+ .a`F r �''�t 'Y � Iu w H 4 M <br /> �i '�C� �44'tiln 1(� � �yt,N a�.0 .� � '�x',��� Yi `v. ��vw �t � �''(R�+ ^jW�, <br /> '_ ` y M1.um�w 'T ,,,iK �'�.� [r f� ,�'�, f �`!,�+ i�Y1'�,+ `�� 9�H�W� h fSAh u��'�R'Y i q�i 4 <br /> •.4��'1�'9'� �F � Lr ���'' >�i""��.'1��' `��ll'�,v�h �FU�r ,, <br /> � „ �. ;..�:ti. .i��nr� Y�nuR+h."���r�li"�'�� <br /> ❑ Yes,this section applies <br /> 7'he replacement of a si ti 1 fi tu or I'a,nc thai meets all three af the tbllowi�ree�uirements� <br /> 1• oe not require modiftcation w electrieal oc gas 9ervice, <br /> Z. Fias a lot co t of$500.00 or less; xcl din the eost of the fixlure or appli��;�d <br /> 3. Is improved, installed o�repjaced by the homeowner or licensod eonttt�ctpr, <br /> Skip next section,ifthis appl�es; Cost ofPcrmit <br /> State Surch�rge $15�0 <br /> Mail-In l�ee(TfApplicablo) $pp <br /> Total Permit Feo —?. <br /> $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />