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. <br /> .�'LLTR�'B�NG`r FI3�.�7C[JLZ�S BE�G�tSTALI.��. ' <br /> FIXT[JRE BSMT 1 2 OTf�R FIXTURE BSMT 1 2 OTf�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � 3 2 Floor Drains 3 <br /> Lavatory 1 4 2 Sewer Ejector <br /> Bathtub � � Laundry Tray 1 ,) <br /> Shower ,� 2 ,� Washer 1 ,) <br /> Kitchen Sink ,� Water Heater ,� <br /> Disposal ,� Water Softener ,� <br /> Dishwasher ,� Wet Bar ,� 1 <br /> Sillcocks 3 Miscellaneous <br /> �� �'RI�t3`FEE CALCULATit?l��S� ��. <br /> ��SED QFF-2�42�TA'i`E S'�A�'� <br /> ❑ Yes,this section appli� <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> l. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less; x 1 'n 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 Permit $ 15.00 <br /> State Swcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Neat Page) <br /> 2 <br />