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��_``:`_. '� P�,CTI��N�F��TVRES BEII*l�Z Ii��Tt�LLED - <br /> FIXTURE BSM'T 1 2 OTHER I'IXTiJRE BSMT 1' 2 OTHFR <br /> 1'}'p� FL FL TYPE FL FL <br /> Water Closet Floor Draii�s <br /> I.avatory Sewer Ejector <br /> Bathtub Laundry 7'ray <br /> 5hower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous � <br /> �'E�tMTT F�E CALCUI,ATIt?N�S) , <br /> B�ED(�FF -2�}U2�Tl�'TE STATUF,'' <br /> � Yes,this seetion applies <br /> The replacement of only one�tesidential fixture or aopliance,thai meets all three of the following <br /> requirements: <br /> 1. Does not require modification to electrical or gas service, <br /> 2. Has a total cost of$500.00 or less;excludins�fhe cost of the fixture or appliance:and <br /> 3. Is imprvved,installed or replaced by the homeawner or licensed pl�mbing contractor. <br /> Skip next section, if this applies; Cost c�f Permit $ 15.00 <br /> State Surc(�arge $ S.dO <br /> Mail-In Fee(TfApplicable) $ 2:00 <br /> Total Permit Fee $�� (j <br /> (Permit Fees ConNnued Qn Next Page) <br /> Z <br />