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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 /> -� <br /> Lavatory Sewer Eje�tor <br /> Bathtub Laundry Ttay <br /> Shower Washer <br /> . Kitchen Sink Water Heater <br /> � <br /> Disposal Water Softener . <br /> Dishwasher Wet Bar <br /> Sillcocks , Miscellaneous <br /> ❑ Yes,this section applies ' > <br /> The replacement of a Residential fixture or aapliance that meets all three of the foltowing requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost df 5500.00 or less;excludin¢the cost of the fixhue or appliance:and <br /> 3. Is improved,installcd or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit a 15.00 <br /> " ► State Surchazge ' $ <br /> � Mail-In Fee(If Applicable� $ 2.00 <br /> Total Permit Fee � e <br /> � ._ <br /> � ' ... , <br /> . » <br /> (Permit Fees Continued On Neat Page� <br /> - . , <br /> * <br /> 2 <br /> � <br />