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„:PLUlVIBING,FIX'TURES BEING;INSTALI ED 2 . ' . <br /> FIXTURE BSMT 1 2 ND OTHER FIXTURE BSMT 1 2 N13 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet C 3 Floor Drains <br /> Lavatory 'S Sewer Ejector <br /> Bathroom ! Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> � l � <br /> Disposal CJ U D Water Softener <br /> Dishwasher f Wet Bar <br /> Sillcocks C Miscellaneous <br /> FE'PIN �CATULAT10,_(7)�u <br /> fi s7J�r✓s < ht £ <br /> Y1 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; 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 Permit $ 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 />