|
02/09/2015 14:a5 FA% 9529a35049 CULLIGAN MNTKA f�003
<br /> r�'�Y+i'�YLI�f4'l���,.i���t�.�i���••.`vy�:i+.�. ia �.� � ; I.�'i7!�/�� 4�. X � �"'^�5?�k'�irl��!�,'}�n•'.''�y':1�Y•.`I
<br /> 4 ru �� '��;;�� �r���,kr�4d, „c.w>r
<br /> FIXTURE BSMT l 2 OTF�R FIXTURE BSMT 1 2 OTHER
<br /> '1"YPE FL FL TYPE FL FL
<br /> Water Closct . Floorl7rains
<br /> Lavatory Sewer Ejector
<br /> Ba�tub Laundry Tray
<br /> Shower Washer
<br /> Kitchen Sink Water lieaier
<br /> Disposal Water Softener �
<br /> Dishwashcr Wet�ar
<br /> Sillcocks Misccllaneous
<br /> �_roi'�a9+�':,i �W-'{,•c�ta��.�j.r.�. •.�b�• "vm:au� ��y���r ��+�,�.� �: • : r w;�� f',i� n'ti• r iu
<br /> �Fr'� � :d " ;� •�;�`�'�,��y�`:'�'�1;�'i,i,.lJ.:�„' '* �� �r°r � ",,$;� 1Yn�:r�c!` d,:.
<br /> y�,�,,�L• l �5 ;��be{y� f'�r���,A , � � �' , '�f,.,�.',!:u:.�-`,4.!;�i�'4 �r�,r .W�•.� a,; ,
<br /> r •r�,�R`��;; •(-�. ,�;,�= 'r.�, �, `��r,.. T ,,,,:; ,..�:�, t;r,.�; �S: 5
<br /> iM' i r i1� '�'�, �1,��� 4 �a. N 4 .r;•.,f a e. N• •r..s�N �i.ln. ' .�: �i,, i i•� �����
<br /> �in;i�aV'��;,T�'�i�r�''�;,TI^"IStI�:��µ.:tiev �� ^� �+y�,y;+� .}nI a{�°, '7'x,.,�,��i!�r+�,�� ,��".' ;.,�,�L1�� ,�'(r{Fr�' �, ��� •�''r�
<br /> A� ;P,n?j-"�, aq�/I��G'.� .ti'� i � r o In� t. i,• ��.1"; ��''��,�' ^!"%'tai,f
<br /> :e.,9k'L �r^ ,�i„ ��' �4�'�1.r'JJ„�J�r��i4�f��i:l��j..l',�''i„►7`1Cl��,i+'� :1��di, �a�.'f�.w�,:q',�,�;,�;';
<br /> ❑ Yes,this section applies
<br /> The replaccment of a Residenti�l fixture or appliance that meets a�l three of the follawing rcquirements:
<br /> l. Does not require modi�ication to electrical or gaa scrvice. .
<br /> • 2. Has a total cost of$SOOAO or[ess;excludin¢t�7e eost of the fixt�ue or appliance:and
<br /> 3_ Is IInprove�jnst�alled or roplaced by the homeovvrer or licensed contractor.
<br /> Slop next scction,if this applies; Cost of Permit $ ]5.00
<br /> State S�charge $ 5_00
<br /> � Mail-Ia Fec(If Applicable) $�
<br /> Total Permit Fee S
<br /> (Pcrmit Fces Contivaed On lYext Page)
<br /> 2
<br />
|