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09/29/2014 19:13 FAX 9529aa5049 CULLIGAN MNTKA f�003 <br /> ` . <br /> I <br /> ��� '.�, . �:;" � '��'�T�;�'LT11+�B'Ily�,�'L�'L��`���1'G..A�ST�'�`Y:�D'.,` ��;,.�'� ;,;�. <br /> FIXTURE BSMT 1 2 OT[��R FIX1'CJk2E BSMT 1 2 OTHLR <br /> '�� FL FL TYPE �'L FL <br /> WAter Closet Floor 17rains <br /> �v�OrY Sewer Ejector <br /> ���b Laundry Tray <br /> Shower Washer <br /> � Kitchen Sink Watcr Heater <br /> Disppsal Water Softener <br /> Dishwasher Wet$ar I <br /> Si]1coGks Miscel laneous <br /> ��� � t � +�,eZ��°� e F f "n;d�ai'r . i � �a ,�c u �:, �,y �,,� �y I�( <br /> �'A" �y ,{ .�°'�`*y'S.T ��b �ir4'�Ijj�}�,j�l'��k�; �i � ��'� � n r ° � ''�f�4��'�'�'�'.r�!'��'%.�A�Y4�F'�ry,7"Y�Iy'.�Y''�1 JW� ,7;'!Ik�i��� <br /> { '�7 ����`M �'l�d"_h dP�� i USti'•�� i � n.�ih. � .,,� ��, �✓,i���7 d ���• 7� <br /> .�1� 1 4—•�C A Y' h f,�P' .� <br /> , i'4 ,�{�;�yrd� �'; '� 13� N,�. t;� �+f�' a, � W <br /> �dh %�" `�r��.���t1��'+,4r� �;r,'i�rm'M:� � ��I� � �' � ?��, 'i re��W��; i�xi� ��'�'U �i+�+";';f�''� �'� r, <br /> � �a.,i�i � �.V�M.�SG,:1'�� ���' '�fi�G.����"��iC�,.Y��M��`n,},!� d`IY��I`�,J�F7��11I ,�'V��'t,�.�.I� <br /> A4L b�A� ��fili f9rN�.6. <br /> � Yes,this section applics <br /> The repl8eemcnt of a esidential f XTurc or liance that meets all�ree of thc following requirements: <br /> 1, oes not reqpire modification to elec�icsl or gas servieb. <br /> Z. Has a total cost of$500.00 or less;excl., udine the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeawner ot 1'leensed contractor. <br /> Skip next secYion,if this applies; Cost of permit $ I S,QO <br /> State Surcharge $�pp <br /> Mail-In Fee(If Applicablc) $ 2.00 <br /> Totnf�'ermit Fee $ <br /> (Permit�'ccs Continued On Next Page) <br /> 2 <br /> � <br /> . i <br />