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; <br /> '_•- _ _ :v�:�l' 1... \ �Y'~ �` T��.��"Ka•...�1�..' . <br /> `;cc.:i:``t. .;.�",�'`ti �` ,4�7v+.,..h'`�'�:..�`u`tti, .y�,+�. <br /> :��a:��vi'•�" <br /> E�[X7'l.1RE BSMT 1 2 O'TI�R FIXTURE BSMT 1 2 O"THER <br /> TYPB FL F'L TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathroom ���Y T�Y <br /> Shower Washer <br /> Kitchen Sink Water Heater � <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Siltcocks Misceilaneous <br /> � ������ �������"�.��..�'�'������ � <br /> � <br /> .�� � <br /> � <br /> � ���s�.��#�� ; �€�� ������"�'�`�Y.�� <br /> �._: <br /> . , , ;: <br /> .. �.:..:::.:,;.:.:-.: <br /> ��..,�.�.�_..�._._....._._..W.._.....�...._V..w.....�.._, <br /> _...._��__.�x..�...�.�._y..��_...�.��.�,vMW�......_,. -=.�....,...-:.. <br /> ❑ Yes,this section appiies <br /> The replacement of a Residential fixture or appiia�e that meets all three of the following requirements: <br /> 1. Does not require madification to electrical or gas service. <br /> 2. Has a totat cost of$500.00 or less;excludin�tbe cost of the fixture or appliance:and <br /> 3. Is unproved,installed or replaced by the hameow�r or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Stucharge $ .50 <br /> Mail-In Pee(If Appiicable) � 1.50 <br /> Totat Permit�'ee $ <br /> (Permit Fees Continued On Nest Page) <br /> 2 <br />