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.' ` � .",. �' ��� ., �,��'� , ;., .,.,.- `����^��- �i�. <br /> � <br /> S 4:r i <br /> . <br /> 4 ' <br /> .. . i . ` . . � . � . <br /> ' r . '... . ��.^:. " <br /> FIXTURE BSMT 1 2 OTHER 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 Washer <br /> Kitchen Sink Water Heater <br /> Dis�fosal � Water Softener <br /> Dishwasher Wet Baz <br /> Sillcocks Miscellaneous <br /> , r � � � <br /> - ��r r c �� � �� �+ ` �3 ��� � <br /> T ��� � ��������L��� � �4„ � �rr� <br /> Yes,this section applies <br /> "I'he replacement of only one Residential fixture or appliance that meets all three of the following <br /> requirements: <br /> 1. not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;exciudins the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or ticensed 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 Fee $ <br /> (Permit Fees Continned On Next Page) <br /> 2 <br />