|
04/23/2014 11:57 FAX 9529335049 CULLIGAN MNTKA f�003
<br /> �
<br /> ,.: ..�.. ... .,
<br /> :..:..:.:.:. .:........
<br /> ,: :-
<br /> ;::, :.{ .:_. . ..: -
<br /> ,:,:�:
<br /> ....
<br /> .,,,..::••
<br /> ,:.�..-�., ,<'
<br /> ;.:.
<br /> . . .., . �Y .. �,:'
<br /> . ... � : � �.'
<br /> '��t.:.:. .:...:...�.... :.,� ..:. ...... . ,. :.�"„
<br /> FIXTU1tE BSMT 1 2 OTFiEit FIXTURE BSMT 1 2 OTHER
<br /> TYPE FL FL TYPE FL FL
<br /> Water Closet Floor Drains
<br /> Lavatory Sewer Ejector
<br /> Bathtub Laundry Tray
<br /> Shower W asher
<br /> Kitchen Sirilc Water Heater
<br /> Disposal Water Softener '
<br /> Dishwasher Wet Bar
<br /> Sillcocks Miscel laneous
<br /> �� 'i�.iY�'.!�. .,�"-'�1 's'`� � h '� . h �i'i.»��'� �y;����ih��� .y
<br /> �11 II . �.F,p P S) S`,", n'�y -�1'L Y, . 1{
<br /> '�-,. ;;m�i: 'r�' �iy:;;iiti�-'�',L�i��S��t .fi�f•�L'�SC`'.+,.. _ a, �� t ) �i;'G�.''„��'..H,�;�e Yi,: i;�.
<br /> ,� kr'.p � �r � .r.,t ,i �'��'S:�� nr.' :h•'i�^ri:.1� .�:��,�! S.b:e�`tq .� r���
<br /> :`5�.1�'v;��{�`ft,�u��.%�r�'��t.t�k�� _.D.��'�o�.� �' ��'',tt �.���':"} ijr.t.n�4,F�J�� +:.;
<br /> �''�i':�;i'?'�k NYw�`A�E�,-����>N`�;i;iyFv�',�,x�,�;.�i�'a .:� .JR .. �;q.� •-�:31: ��•,r}4�*,�'�.,�h^,., ajij'�"ja�!p t' ...�' ��
<br /> ..�.. �, ��i:,�. 9. .?� t�tl4„ ..��� ::�.1.. P ;;�a';;:.(�'�;7,�_;, .'J:r.r.� n. ':T r,�,`�_�`s,F.7
<br /> ❑ Yes,this section appties
<br /> The replacement of a�tesidential fixture or ap,pliance that meets all three of the following requirements:
<br /> 1. Does not require modification to electrical or gas service.
<br /> 2. Has a total cost of$500.00 or less;excludin¢the cost of the fixture or appl iance:and
<br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor.,
<br /> Skip next section,if this applies; Cost of Permit $ 15.00
<br /> State Surcharge $ 5.00
<br /> Mail-In Fee(1f Applicable) $ 2.04
<br /> Total Permit Fee S
<br /> �
<br /> (Permit Fees Continucd On Next Page)
<br /> 2
<br /> ;
<br />
|