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48/13/z01a wED i0: 3a aAx 763 a73 8565 Sabre HOdting s air Cond �003/007 <br /> 1713CTURB BSMT 1 2 0'IT�R FIXTURB �SMT 1 2 OTFL� <br /> 'TypE FL FL TYPB � �Y- <br /> Water Closet � � Floor Drains � � <br /> Lavatory G Sewer Ejector <br /> J <br /> Balfitub � Y.,aundry Tray ' � <br /> Shower { Washer I <br /> I <br /> Kitchen Sink ( Wateir Heater I <br /> Disposal � Watar Softener <br /> Aishwasher � Wet Bar � <br /> Siilooaka .� , 1 Miscellan�ous <br /> r,� <br /> ❑ Yes,this sdction applies <br /> 'T'he replacement of only one Ra9idential fixture or aooli�nce that meets all three of the following <br /> rCquirements: <br /> ], p,�n�require modification to electrical or gas service. <br /> 2, Has a�of�500.00 or less;y�j�g tha cost of the fuctu�a or appliance:end <br /> 3, ls improvod,installed or raplaced by the homeowner or licensed pluxnbing contractor. <br /> Skip next section,if this applias; Cost of Permit $ 15.00 <br /> State Surcharge S S,i� <br /> Mail-In Fee(If Applicable) � 2.� <br /> Total Permit Fee S <br /> (Permit F�ea Continaal On Ne�t Pa�e) <br /> 2 <br />