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FIXTURE BSMT 1 2 OT'I�R FIXTURE BSMT 1 2 OTI�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet 1 � Floor Drains i <br /> � <br /> Lavatory i ` , f Sewer Ejector <br /> ( � �..1 <br /> Bathtub � Laundry Tray <br /> Shower I ( Washer ( <br /> Kitchen Sink ' Water Heater f <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> � <br /> Sillcocks ,Z Miscellaneous <br /> ❑ Yes,this section applies <br /> T'he replacement of only one Residential fixture or appliance that 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;excludine the cost of the fi�cture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Nezt Page) <br /> 2 <br />