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, �` <br /> �, �,'�T��F, �„��� �;;UR���BE�Nfi.r.IltiTSTALLE�3. � . .. ;,,�;E, <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTI�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathroom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> - ��:. "� .i: ���.+y{�, jf�i;` $�Yy, ��y{ (�'yA`�[^J{+{'^^^,���}'''']{.yl�� T � � , _ ;,,,,;�: <br /> _ ��§A Fit� "���....��T��.�A-�.i'.t,�rr/4��{�✓,V3J�.�..C�� � � .. ' �:��' <br /> _ +yy� .t �il y� /} (� �yf�a y!y�r�y�y�"�� . � <br /> ' ' ,'S�. ��L.`i��������4�(+f���.L 1�.M 3 l}.J:W....w�' . . A�k <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 modificatio�to electrical or gas service. <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 replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surchazge - $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Nezt Page) <br /> 2 � <br />