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, <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � Floor Drains <br /> Lavatory � Sewer Ejector <br /> Bathroom Laundry Tray <br /> 'f'U� f <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or a�,pliance that meets all three f the following requirements: <br /> 1. Does not require modification to electrical oc gas se ' e. <br /> 2. Has a total cost of$500.00 or less;excludine e c t of the fixture or appliance: and <br /> 3. Is improved, instalfed or replaced by the home er or licensed contractor. <br /> �� <br /> Skip next section, if this applies; _�ost of Perm $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Ap licable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />