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��IJIVIBNG�FIXTURES"-BEING�INSTALLED . ` ' <br /> FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1s1 2ND OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> c:210/yr <br /> Lavatory Sewer Ejector <br /> � � 5 <br /> Bathtub Laundry Tray 1 <br /> Shower n Washer <br /> Kitchen Sink I Water Heater 1 <br /> Disposal Water Softener <br /> Dishwasher 1 Wet Bar <br /> Sillcocks f Miscellaneous <br /> PEt1VIZT FEWCALCITl<A2IOs),f, ` = t � , G <br /> 5 ' _ `:rr BASED QFF 2002 S'I`A,'TI SPATT E; ,; k 3 ; <br /> . <br /> ❑ 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 . s <br /> x ,S <br /> - • f x <br />