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. � <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � Floor Drains -� <br /> Lavatory y Sewer Ejector <br /> Bathroou� �;.r� � Laundry Tray � <br /> Shower Washer , <br /> Kitchen Sink , Water Heater 1 <br /> Disgosal r �✓ater Scftener � <br /> Dishwasher ' 1 Wet Bar ' <br /> Sillcocks � Miscellaneous � � <br /> i '�t r <br /> r\Y . ���,,�'�c' LL i't .' r: <br /> � Q�� c,�� � s�„� �%�,p � ;���,a.�- ,;�t <br /> 1 ;c�mc�s� \;�n� � �-.,;,m�d��e� �;n�.. <br /> � ' . . �,;, ,��V�.[t;i;rn�t�:,�t.Y <br /> , , _PERMIT.FEE C�11LCU��'"�� <br /> �1„fi, <br /> �,�' BASED�OFF�=2002 STA�'��� <br /> ❑ Yes,this section applies <br /> The 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 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 Surcharge $ .SO <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />