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02/22/2011 1123 FAX 9529\335049 CULLIGAN MNTKA e003 <br /> Sari si[K��'� ,C �:�*' �� %'!"t� *R �rr£.a-�'i'J'�'�',',"r�j'f'�.�r�r ti. �ti ��,yr <br /> '+l�-�+.I N l + ,r�b,! . G is n � I.r 1!.1�. `.03 .,�:.!�.�+:.: .� n�a:L'1.,,,." ,i�.; f.::' �7 1 <br /> FIXTURE BSMT IsT 2N° OTHER FIXTURE BSMT 1sT 2''1D OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Batljtub Laundry Tray <br /> Shoyl ver Washer <br /> Kitchen Sink I Water Heater <br /> Disposal I Water Softener I <br /> Dishwasher Wet Bar <br /> Sillocks Miscellaneous <br /> • <br /> ��r 1rr �Sd �a a 1y r <br /> "�'`�'�ir.:a ti;��'-e�S� 'k.�;N�t'iiu�?''� "�*�,.a 1s�t7a�dMv' +�.....€fit 1„,� ,.»'��1`:.�: X; ,ti J 3� r.. r.�'kh1.t. wC$^,., ,.,1#1ti'Aiiz4` <br /> ,\ Yes,this section applies <br /> i I <br /> The replacement of a Jtesidential fixture or fioplian4e that meets all three of the following requirements: <br /> I <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Hiss a total cost of$500.00 or less;ex luding the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by t e homeowner or licensed contractor. <br /> S up next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee S <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />