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� <br /> .- , <br /> R ' <br /> � �,:�:. �., ,: � ;�,PLL7MBING.FIXTURES����1NG`INSTI�LL-�D� x : � �° k F,. , <br /> FIXTLTRE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejectar <br /> B athtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal / Water Softener <br /> ( <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> *1 ,.. x 4 1� "9 ���'^ "5. tn,�} �; �r Ff'�.�.r�,� � - .r qf .f F.. <br /> ��` �"��`+'��� �4.e �T 7 '�'.b�',��'',�,���,�.����ru"iG� � ,��•��w������t�t'�H�� ��9r���,,� ��,.�t t pY�t *°{: <br /> a���' '�`'` M �' "Ca}e F E'�"'�'4 a� �(�... d 1 h�.rt t�.:*i � ,w/�.c/�*� (�+�. "a � .�r a.��' �� ' u. +f�.�;� y u. <br /> f,�a7A}.� �`��� �-_f�ro�i5�;�j,,,�c St��1�1'1���41��L'� �1JV,lu 1.)1°��:������k.�,`r�a. y k�' k tnq�`��-",�ui,� <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixiure or a�pliance that meets all three of the following requuements: <br /> 1. Does not require rnodification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excluding the cost of the fixture 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 Pernut $ 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 />