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_ .: . . ,, � . ; , _ <br /> ., <br /> �as, ,.r <br /> � �, f�;, <br /> .�,' � <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTF�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory I Sewer Ejector <br /> Bathroom Laundry Tray <br /> -F"11�b � <br /> Shower W asher <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> -�_PE�IVI[T PEE CALCU�A.TI�N(S} ,:° ' � 3 <br /> < , . '.SAS�D OFF -2002 STA"1"�STATCJ�,B` ; <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;excludin¢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 $ I5.00 <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 />