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, , 1 � <br /> �yX <br /> t� � ��.� • � <br /> t/ <br /> FIXTURE BSMT � 2 oTf�x r�xTURE <br /> TYPE FL FL TYPE <br /> Water Closet ��r�� <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray . <br /> Show� <br /> Washer <br /> Kitchen Sink W�H� <br /> Disposal <br /> Water So$ener <br /> Dishwasher W�� <br /> Sillcocks Miscellaneous <br /> :�:; ��r <br /> :# <br /> � Yes,this section applies <br /> The replacement of a Residential filcture or anniiance that meets ail three of the following reqnirements: <br /> 1. Does not reqaire modification to electrical or gas service. <br /> 2• Has a total cost of$500.00 or less;excludi�the cost of the fixture or appiiance:and <br /> 3. Is improved,inshalled or replaced by the homeowner or licensed contractor. <br /> Skip next seclion,if this applies; Cost of Pemvt <br /> $ ]5.00 <br /> State Surcharge a .SO <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee s F�, � <br /> -�—f— <br /> (Permit Fees Continued On Nezt Page) <br /> 2 <br />