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<br /> FIXTURE BSMT 1ST2NDOTHER
<br /> FIXTURE BSMT 1ST 2ND OTHER
<br /> TYPE FL FL TYPE FL FL
<br /> Water Closet l Floor Drains
<br /> Lavatory1 Sewer Ejector
<br /> Bathroom Laundry Tray
<br /> Shower Washer
<br /> Kitchen Sink Water Heater
<br /> Disposal Water Softener
<br /> Dishwasher Wet Bar
<br /> 1
<br /> Sillcocks Miscellaneous
<br /> .7"4,0441, 4t- i y Agin),
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<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
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