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, � <br /> � <br /> . <., , . ,. , <br /> ��� � ��"�� '� ��� <br /> � . . . .. <br /> . � .. <br /> �. . <br /> : - , �. . _ _ _-,���r- e= . � <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> I,avatory Sewer Ejector <br /> Bathtoom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellat�eous <br /> '��. ' � ` '����� '�;:� ... - ��i F�e,�e��:�, '�` �,�s � �- . <br /> 7 � <br /> `� >�,x . k� a :-r��71v-�;u, ���'�t�� `�a �. <br /> I � , _ - 3�..j� ' �. 1- � .� <br /> ``5f e� .+Y`'F�� _ �� <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixttu+e or appliance that meets all three of the following requirements: <br /> 1. no require modification w electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excluding the oost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contcacWr. <br /> Skip next secrion,if this applies; Cost of Permit S 15. <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fce S� <br /> (Permit Fces Continaed On Nert Page) <br /> 2 <br />