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03/07/2017 TUE 14: Q2 FAx 763 673 8565 6dbre xedting � Ai.r Cond �003/004 <br /> ��dXTURE BSMT 1 2 0'THER FIX'TURE BSMT 1' 2 OIT•ll3Tt <br /> TYPE FL Fi, `I'Y�E I+L 1�L <br /> Water Clpset Floor Drtins � � <br /> I.avatory Sower�jector <br /> �athtub I,aundry Tr�y <br /> Shower Wash� <br /> Kitchm Sink Water He�ber <br /> Aisposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> � Yea,tfiis axtion applies <br /> Thc roplacamant of only ono I�idcmtial fi�ct�rce or appliance that mee�s�ll three of the following <br /> C�uiremente: <br /> l. poes not require modi�cadon to olcctrical or gas scrvice. <br /> 2. Fias a�of$500.00 or lesa;exclvdine tha wst of ti�e fixCure or appliance;and <br /> 3. Is improvcd,installed or replaced by the hpm�v�n�er or lieensed plumbing cont�actoc <br /> Skip next section,if this spplios; Cost of�ennit S_ 15,00 <br /> State 5urcharge S 5.00 <br /> Mail-In�ee(If Applicable) $ 2.00 <br /> Total Pe��miE�'ee S <br /> (Permif�eea Cotttulued Un NestPagc) <br /> z <br />