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. <br /> � - . <br /> ;C_ -- �,s y��. � <br /> FIXTURE BSMT 1 2 OTI�K FIXTURE BSMT 1 ' 2 OTI�R <br /> TYPE FL FL TYPE FL FL <br /> Wxter Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> � <br /> Bathroom Laundry Tray <br /> ' Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposa] Water Softener <br /> Dishwasher Wet Baz <br /> Sillcocks � . IVTiscellaneous <br /> . • "� <br /> � Yes,this section applies . , <br /> The replacement of a Residential fixture or appliance that meets a11 three of the fo(lowing 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 /> ,� <br /> Skip next section,if this applies; Cost of Pemut $ 15.00 <br /> State Surcharge $ .50 <br /> , Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee �� <br /> . ' • <br /> (Permit Fees Continued On Nest Page) - <br /> 2 <br />