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12/09/2013 15:14 FAX 9529335049 CULLIGAN NNM IM 003 <br /> FIXTURE BSMT 1 2ND OTHER FIXTURE BSMT IST 2 NDOTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> Yes,this section applies <br /> The replacement of a Residential fixture or jMliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service, <br /> 2. 'Has aLo.W cost of$500.00 or less;excludins the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,ifthis applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />