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FIXTURE BSMT 1 2 O'IT-IER 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 W�B� <br /> Sillcocks Miscel(an�us <br /> � <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 tequire modification to electrical or gas scrvice. <br /> 2. Has a total cost of$500.00 or less;excl ' the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeownea'or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ I5.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Nezt Page) <br /> 2 <br />