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02/28/2012 19:47 FAx! 7634775629 �008/009 <br /> Y ' � �� <br /> . o��� ;' <br /> � , <br /> , , <br /> FI BSM1' 1 2 OTNER FIXTURE BSMT 1 2 O <br /> TYPE ! FL FL 1YPE FL FL <br /> Water IosCt �`lopr Drains <br /> Lavatory 3 s�w�r E;oocor <br /> Bathlub 2 Laundry 1'ray <br /> 5how¢�' l Washer /. ' <br /> �{itch n Sink ! Water Heater <br /> . .. _., :. .. ... Disp�sal_ _ . .,.-_ . . . ./ Water Softener � ,,. ,, <br /> Disl�vashcr / Wet Her <br /> � ;,: , <br /> Silldocks Miscellaneous <br /> � <br /> i <br /> i <br /> i <br /> i _. _ <br /> a ' 'ii� � <br /> �� ��� <br /> I <br /> �] Yes,this section applies <br /> '�hc rcplaccmcat of only one Rcsidcntial fixturc or a,ppliittice ihat moe[s sll chtee of the fol low g <br /> tequiremenu: <br /> 1. Doos not cequire modificat,ion bo electrfcal or Gas serv;ce. <br /> 2. Has a�,.�of 5500.00 or lesa; cl 'n tha cost of the Sxture or applience and <br /> 3. is improved,installed or roplacod by the homaowner or licensed plumbin�con o <br /> , Skip nex[section,ifthis applies; Cost of Permit S IS 0 <br /> -State 5wcharge $ <br /> Mail-in Fee(Tf Applicable) S <br /> -Total Permit Fee S <br /> � <br /> � (Permit Fee�Continued On Neit P�ge) <br /> 2 <br /> i <br />