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• <br /> 4 '44 4444 „,; PLUMB NG FIXTURE-8ttiNG <br /> FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT lsf 2ND OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellan ous <br /> s Et a' r A4' <br /> P 74 'k g4 sa a $ + c- T,, &t1°��x a r;�'��' `s`ks x#X' ” - R b< ')"" t�,+a�, -1t1tvi yq ' $ <br /> Yes,this section applies <br /> The replacement of only one Residential fixture or appliance that meets all three of the following <br /> 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 plumbing 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 $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />