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..t . ! <br /> FIXTURE BSMT 1 2 OTI�R FIXTURE BSMT 1 2 OTF�R <br /> T'YPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathroom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink ) Water Heater <br /> 1 <br /> Disposal / Water Softener <br /> ( <br /> Dishwasher � Wet Bar <br /> Sillcocks Miscellaneous <br /> � ����� � ����� <br /> � <br /> ❑ Yes,this section applies <br /> T'he 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 fi�cture 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 $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br /> � <br /> 2`° <br />