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Sep 01`15 02:31 p Water poctors 7635351805 p 3 <br /> - . <br /> ° : ��,tr�anvG���s B��vG mT��r�;z;�D , <br /> FIXTURE BSMT ]� 2 OTHER FiXTURE BSib1T lsr �^ OTHER <br /> TYPE FL FL TYPE FL FL <br /> VJater Cbset Ploor Drains <br /> Lavatory Sewer�jector : <br /> Bathtub Laundry Tray <br /> I <br /> Sl�owcr Washer <br /> Kitchen Sink Vi�'ater Heat�r <br /> Disposal 1Y'ater Softener <br /> Dishwasher lt�'ct Baz <br /> Sillcocks Misceltaneous <br /> � <br /> ` PERi�T FEE CALCULATION(S� . <br /> :, _ .S:A.SED O�F-2EK12 STA7'£STt1TUE _ <br /> � 1'es,this section applies <br /> Tlic repl:►cement of ottly one Rcsidcntial Gxture or appliance that meets all tl�rcc of ine following <br /> requirements: <br /> I. Does not require modification to electncal or gas servicc. <br /> 2. 1Ta,e a total cost of$SOO.QO or les5;excludint*the cost of the fixture or appliance:and <br /> 3. is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip nexl section,iftl�is applie:s; Cusl ofPcr�nit $ ]5.00 <br /> State Surchar�;e $ I.QO <br /> Mail-in Fcc([f AppIicablel $ —2.d� <br /> Total Perrnit Fee s�(z,� <br /> (Pcrmit Fees Confinued On Ncxt Pagc) <br /> 2 <br />