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. • - r <br /> L <br /> ,£ .i <br /> ° `�.. <br /> FIXTURE BSMT I 2 OTI�K FIXTURE BSMT 1 ' 2 OTFER <br /> TYPE FL FL TYPE FL FL <br /> . Water Closet Floor Drains <br /> � Lavatory Sewer Ejector <br /> � <br /> Bathroom Laundry Tray ' <br /> � Shower Washer <br /> I�itchea Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> � Sillcocks ` . NTiscellaneous <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 modific�,tion to electrical or gas seivice. <br /> 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and � <br /> 3. Is improved,installed or re�laced by the homeowner or licensed contractor. <br /> u <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surchazge $ .50 <br /> , Mail-In Fee(If Applicable) $ 1.SU <br /> Total Permit Fee $� <br /> � . . <br /> (Permit Fees Continued On Next Page) - <br /> Z <br />