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tzr <br /> 0 <br /> 0 <br /> N <br /> 0 <br /> 0 <br /> tt <br /> 0 <br /> co <br /> FIXTUREBSMT IS7 2`D OTHER 1 FO(TURE BSMT lsr 2" OTHER <br /> TYPE l FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> m <br /> 0 <br /> .. Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> ) <br /> o Shower Washer <br /> Kitchen Sink Water Heater <br /> CO <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> 1_ <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 015500.00 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 S 1.00 <br /> Mail-In Foe Of Applicable) 5 2.00 <br /> Total Permit Fee S <br /> to <br /> (Permit Fres Continued On Next Page) <br /> rl <br /> to <br /> 2 <br /> 0 <br /> tL <br />