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. <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> T'YPE FL FL TYPE FL FL <br /> Water Closet Floor Drains I! <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray ! <br /> Shower Washer ' ' <br /> � <br /> Kitchen Sink Water Heater ( I <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous , <br /> � <br /> II <br /> , <br /> j <br /> ❑ Yes,this section applies <br /> ,I <br /> The replacement of a Residenrial fixture or anpliance that meets all three of the following req�iirements: <br /> i <br /> 1. Does not require modificarion 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 secrion,if this applies; Cost of Pernut $ � 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ I 2.00 <br /> Total Permit Fee $�t <br /> Permit Fees Continued On Nezt Pa e I <br /> � g ) � <br /> 2 ' <br />