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EST, T, <br /> x:: <br /> .J. ••Y/N' <br /> FIXTURE BSMT 1 2 OTHER FDMJRE BSMT 1w, 2 OTI-MR <br /> TYPE FL FL TYPE FL FL <br /> Watcr Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bariftb Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Sof ter <br /> Dishwasher Wet Bar <br /> 770cks Miscellaneous <br /> .. .. ..,«,'; ...'hi •].W.:.•;.;. .._;. ,f . .;',.•�;;,�•. ,:,. tw..... x;11„;,,,w,• 3:.•s <br /> w:t:.,`.'.s fir. ..' s.i�'.N'.N',.i ,Ya>..i•b^' � , ki y`<�• J. x, 'f <br /> ❑ Yes,this section applies <br /> The replacement of a Residential future or appliance that moats all three of the following requirements: <br /> 1. Does require modification to electrical or gas service. <br /> 2. Has a MW co of$500.00 or less;milding 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 $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ 22-00 <br /> (Permit Fan Continued On Neat page) <br /> 2 <br />