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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT ] 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water C(oset Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathroom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink � Water Heater <br /> Disposal � Water Sofrener <br /> l <br /> Dishwasher I Wet Bar , <br /> Sillcocks Miscellaneous <br /> i <br /> i <br /> ` , � �ExMr� � � <br /> � i `��,' ' BASED O�� �� ��,�ti ;Y � <br /> � ���_ � <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> ]. Does not require modification to electrical or gas service. <br /> 2. Has a tota(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 Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> i <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />