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s 1 � �' �:'�a�� ��.+���..�i s �� ,k�'��.,....a� #F- <br /> �,rs...k.,,;� �,v„>� g i :.,� . <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 /> Shower Washer <br /> Kitchen Sink Water Heater ) <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> ��r, � � � � <br /> ,4" 2 3��°r2 �� , �-. <br /> a <br /> y,� <br /> a r ur� <br /> .. ��� p�� � � . ... .. <br /> ,�'§r..<,.�.:. . .....lE�, .:•::. n,. , ,...:<,� . ..�.. �.,> 1 .; . ., ,� <br /> .. . ;�.�_ . .', , ...,,, . ,��-. . ' . ._, - ,� ' ,..: �. <br /> � Yes,this section applies <br /> The replacement of a Residential fixture or apnliance 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 fixhue 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 $ 1�.� <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />