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FrOM:13&0 PLUMBING 7634974263 10/09/2013 14:41 #028 P.003/007 <br /> 1 <br /> i <br /> FIXTt1RE BSMT 13T fo OTHER FDMW Bshd IWK 2M OTHER <br /> TYPE FL FL TYPE FL FL I <br /> 3 <br /> water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower wash <br /> Kitchen Sink Water Heater <br /> 3 <br /> Disposal ' water Soilener <br /> Dishwash , wet Bar <br /> sillcocks �H us f <br /> t <br /> f <br /> t <br /> ❑ Yes,this section applies <br /> The replacement of only one Residential fixture or sonliance that meets all three of the following <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excl the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> t <br /> f <br /> z <br /> (Permit Fees Continued On Next Page) <br /> x <br /> 2 F <br /> i <br />