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� <br /> �. <br /> �, <br /> . 'k. � <br /> 1: <br /> s , <br /> . i <br /> �e,�-ac.�e� �qr a�Q <br /> . <br /> �'�`� ����,�:� �� <br /> ��� � -- .� > : �,��� <br /> � . <br /> FIXTURE BSMT 1 2 OTHER 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 /> � d �,¢�,�„ ; <br /> Disposal Water Softener S <br /> s <br /> Dishwasher Wet Bar ; <br /> Sillcocks Miscellaneous <br /> f <br /> � <br /> ! <br /> ; <br /> i <br /> PERMIT FEE CALCCILATION(S) <br /> � BASCD OTF - 20Q2 STAT����STATUE � <br /> ❑ Y'es, this section 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;excludinQ the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section, if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />