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_.._ 04/19/2016 10:a2 FAX 9529a35049 CULLIGAN MNTKA f�012
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<br /> FIXTURE BSMT 1 2 OTHER FIXTUR� BSMT 1 2 OTFIER �
<br /> TYPE FL FL 1'l'1'E �'L FL
<br /> Water Cfoset Floor Drains
<br /> Lavatory Sewer�jector
<br /> Sathtub Laundry Tray
<br /> Shower Washer
<br /> Kitchen Sink Water Heater
<br /> Dlsposal Water$oftener
<br /> Dishwasher. wet Bar
<br /> Sillcocks Miscellaneous
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<br /> C] Yes,�is section applies
<br /> 7'he replsccmcnt of a Residential fixture or anpliance that meets aIl thrce of ehe following requirements:
<br /> 1. Does not require modification to elcca-ical ar gas service.
<br /> 2. Has a total cast of 5500.00 or less;cxcludine the cost of the fixture or appliancc:and
<br /> 3. Is improved,installcd or rcpleeed by the homeowner or licensed contractor.
<br /> Skip next section,iftbis applies; Cost ofPermit $ 15.00
<br /> State Surcharge S 5.00
<br /> Nlsil-In Fee(If'Applicable) $ 2.00
<br /> Total Permit Fee $
<br /> (Permit Fees Contfnued On Next Pagc)
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