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� - �, <br /> FIXTURE BSMT 1 2 OTHIIt FIXTURE BSMT 1 2 OTHIIt <br /> TYPE FL FL TYPE �. FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Baihroom Laundry Tray <br /> Shower W��r <br /> Kitchen Sink Water Heater <br /> Dis�sal � ;L1�.ter Sof',e:ze: <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> `• �;�;'", �`. `�" �'��R.,��'�E�..CALCULATION(S), <br /> ������� . ASED.OFF =2002 STATE�STATLTE �*' <br /> � <br /> Yes,this section applies <br /> The replacement of a Reside�ial fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require moc�ification W electrical or gas service. <br /> 2. Has a t�os of 5500.00 or less;excludins the cost of the fixture or appliance: and <br /> 3. Is im.�,:ov:,d,::,stallzci or reglace3 t-,�i;�e uomeowner or Iicensed contractor. <br /> Skip next secrion,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .so <br /> Mail-In Fee(If Applicable) $ 1,50 <br /> Total Permit Fee $� <br /> (Permit Fees Continued On Nezt Page) ` . , d' <br /> _ • <br /> � 2 <br />