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� . <br /> � <br /> � £'-����'� .� �,�= <br /> ��� =� -.�����; ��'l��IN:G�F - - <br /> � ��-����ET�G-II���;L LEl�.�v� -�-��.��` <br /> _ -� :.�x-� <br /> FTXTUiZE BSMT I 2 OTI�R FIXTURE BSMT 1 T 2"D OTF�R <br /> TYPE FL FL TypE <br /> �- FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> r <br /> Bathroom Laundry Tray <br /> Shower - <br /> Washer <br /> Kitchen Sink Water Heater , <br /> Disposal Water Softener I <br /> Dishwasher <br /> Wet Bar <br /> Sillcocks Miscellaneons j <br /> 1 <br /> .� <br /> � <br /> _ I ' � ` ,FF��� ����rir�EE c �LCITL �z,«���c�� - I <br /> t - _ � a ;����D�oF� - �?�c�? ' - - - _ <br /> � ,�7�,IL_�I,��7�L�1 - - _ � ; <br /> � Yes,this section applies � <br /> . I <br /> The replacemer.t ef a Resideniiai fixture or appliance that meets ali three of the fo[lowing requirements: <br /> 1. . I <br /> Does not require moclification to electncal or gas service. � <br /> 2. Has a total cost of$500.00 or less;excludina the cost of the fixture or appliance:and ' ' <br /> 3. Is unproved,insfalled or replaced by the homeowner or licensed contractor. <br /> i <br /> Skip neact section,if this applies; Cost of Permit <br /> $ 15_00 � <br /> Stata Surcharge $ .50 <br /> Mai- i <br /> . 1 In Fee(If Applicable) $ 1.50 � <br /> Total Permit Fee $`� <br /> I <br /> I <br /> . i <br /> ,, � <br /> (Permit Fees Continued On Next Page) . <br /> 2 i <br />