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; PL� '- .�G.�I,�T ,���' F�fiG�T�T.��;F.�? , <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 /> Disposal Water Softener � <br /> Dishwasher ' Wet Bar <br /> Sillcocks Miscellaneous <br /> � <br /> � . � � <br /> � � � b' YA'kE .Wabl MM�`v.{� �'`} ^.Y � � �� � <br /> �k �Y �` > � � <br /> �y�. �� � :'., � eA��" �'��w � '� � � e� �,. �:��"�xi.� �"��'�,�,�'-`���� �'`�^,. <br /> `� �.L+�: r ,!'."'�a F.�R f.'�Y'.".& �, �.E <br /> �] Yes,this section applies <br /> � � <br /> The replacement of a Residential fixture or appliance 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;excludine 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,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 Continued On Next Page) <br /> 2 <br />