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� . a <br /> s . . <br /> FIXTURE BSMT 1 2 OTf�R FIXTURE BSMT 1 2 OTf�R <br /> TYPE FL FL TYPE FL FL <br /> Water-Closet `'1 � � Floor Drains 1 <br /> v< / <br /> Lavatory � 3 / Sewer Ejector <br /> Bathroom a a l Laundry Tray / <br /> Shower � / � Washer � <br /> Kitchen Sink � Water Heater / <br /> Disposal I Water Softener / <br /> Dishwasher � / Wet Bar / / <br /> / <br /> Sillcocks � Miscellaneous <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;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 /> {Permit Fees Continued On Next Page) <br /> 2 <br />