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PL Gr'�1��E�'►': r.. ��" ._.� <br /> FIXTURE BSMT 1 2 OTi�R FIXTURE BSMT 1 2 OTf�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub ��Y T�Y <br /> Shower W��' <br /> Kitchen Sink Water Heater <br /> Disposal I Wa�So��' <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> �� <br /> L-�j�,Ocv�' L�'v�G ��GP� �E'DOf1�//P/'� Ti��-T <br /> s�v�S rH� �-Tnl� �jYsT�.�/. <br /> II � r�;5'T�b 2PZ �'�/�t�-� 2��yls= o,� <br /> � l�Bur�T /�PZ S�i� ���oy�=OKA�TP�'— <br /> j ,�Bui� <br /> � � �� � � : <br /> , � �� <br /> "�� �� �`' � n�:� �. <br /> w� <br /> ❑ Yes,this section applies <br /> The replacement of only one Reside�tial fixt�ue or appliance that meets all three of the following <br /> requirements: <br /> 1. Does not require modi�ication to electrical or gas service. <br /> 2. Has a total cost of$5 .00 or less;excludine the cost of the fixture or appliance:aad <br /> 3. Is improved,installed�r replaced by the hom�wner or licensed plumbing contractor. <br /> Skip next section,if th�s applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee S <br /> (Permit Fees Continued On Neat age) <br /> I 2 <br />