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O1/06/2016 wEo 9: 51 FAx 763 �73 8565 Sdbre He�ting & Ai.r Cond �003/007 <br /> � <br /> I <br /> � <br /> � FI?CTU1tL BSM'T 1 2 QTHER P17CTURE BSMT ] 2 4'�'HER <br /> ; '�'Y,PE FL FL TYPE FI, �'Y, <br /> Water Closat � � Floor brains � <br /> I.avAtOry � Sewer Ejector <br /> Batha,b z ��,r�dry Tray , <br /> ShoweQ � � Washer ( <br /> Kitcl�en Sink ' Water IIcatoc t <br /> � � <br /> Dispossl ( Watar Softener <br /> Dishw�sher ' Wet Bar � <br /> Sillcooks � Miscellanaous <br /> � <br /> � <br /> 0 Yas.this section applies <br /> � The replacement of only one Re�idential fixture or applinncc that meeta all three of the follo�wing <br /> � requirements: <br /> I <br /> �. �require modification to electrical or gas service. <br /> ; 2. Has a total cost of SSOO.Op Qr lass;�;1ySl�lg the coat of the�xiure ar appliancfl:and <br /> 3, Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip naxt section,if thie applies; Cost of Pernut ��� <br /> 3tate Surohatge S 5.� <br /> ; Mail-In l�ea(If Applionble) $ Z.00 <br /> Total Permit Fee S <br /> (Permit Fe�Continued On Nezt Page) <br />,y 2 <br />