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08/29/2017 TUE 8: 10 FAX 763 473 8565 Sabre Heating 6 Air Cond 2]006/007
<br /> FIXTURE BSMT 1 sr 71' OTHER FIXTURE BSMT 18T 2m-) OTHER
<br /> TYPE FL FL TYPE FL FL
<br /> Water Closet 1 1 Floor Drains 1 I
<br /> Lavatory , Sewer Ejector
<br /> Bathtub Laundry Tray
<br /> Shower 1 Washer
<br /> Kitchen Sink l Water I{eater
<br /> Disposal l Water Softener
<br /> Dishwasher Wet Bar
<br /> Sillcoaka Miscellaneous
<br /> a c
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<br /> [] Yes,this section applies
<br /> The replacement of only one Residential fixture or appliance that meats all three of the following
<br /> requirements:
<br /> I. Does not require modification to electrical or gas service.
<br /> 2. Has a total cops of$500,00 or less;egductir►g 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 Surcharge $ 5.00
<br /> Mail-In Fee(If Applicable) $ 2.00
<br /> Total Permit dee $
<br /> (Permit Fees Continued On Next 'age)
<br /> 2
<br />
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