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. . .. . - ... � � <br /> . �. <br /> _ _ �: : - - - <br /> ,.. <br /> . , � .. <br /> _ ..: _.. <br /> . . <br /> , , <br /> t .� � �,�r. �.. . .. . - <br /> FIXTURE BSMT 1 2 O"THEIZ FIXTURE BSMT 1 2 OTF�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> � <br /> Bathroom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> - Sillcocks � Miscellaneous <br /> �� <br /> ❑ Yes,this secfion 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 fixhue or appliance:and � <br /> 3. Is improved,instailed or replaced by the homeowner or licensed contractor. <br /> �� <br /> Skip next section,if this applies; Cost of Permit $ 15_00 <br /> State Surcharge $ .50 <br /> , Mail-In Fee(If Applicable) $_�0� <br /> Total Permit Fee ��}l� <br /> ,. ' • <br /> (Permit Fees Continued On Next Page) - <br /> 2 <br />