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' �+ ' <br /> • <br /> ` , <br /> � t` `;° . PLVMBTNG;FIXTURES��BE�NCC�"INSTAT,LED _ .. �, � , �,'� ,. : <br /> �� . �� ,. . � <br /> � <br /> FIXTiJRE 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 /> Bathtub Laundry Tray <br /> Shower Washer - - -- <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar / <br /> Sillcocks Miscellaneous <br /> �d t s�j B�i'-ry�,�k}°�f ���� "dr t�� '�4��R[rM�? ,��1�����d�������� �� �'`� � � � �'�c �".� ���" �'����, a��`�- <br /> °� �"�`?�°� �a'� �'$�t"'2,. � 5.�1r'a § a� � �';�'. � di ��-�:`�� �'r k �. � � a'" a� <br /> * - �P �: ..,�'E� ...,�.��.����� ��Q�� �?i`�',�,�`.�`�- __ . . _a , � <br /> � � `�" � � . . � <br /> �'€'�E �+` .�z'"�'' ra„ r"�'� r a�''n�',,,y,f a 2s ,� .+� .��z� �� y 3 �� R <br /> �.�. �� <br /> � . i . ...�.�n�+� <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 modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin�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 /> (Permit Fees Continued On Next Page) <br /> 2 <br />