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<br /> FIXTURB BSMT 1 2 OTHER FIX�URE BSMT 1 2 07�iER
<br /> TYPB FL FL TYPE FL FL
<br /> Water Closet Floor Drains
<br /> ��ry Sewer Ejector
<br /> Bathtub ��*5'T�Y
<br /> Shower Wssher
<br /> Kitchen Sink Water Heater
<br /> Disposal Water Softener
<br /> Dishwasher �'�B�'
<br /> Sillcocks Miscellaneous (1) RP
<br /> Rebui d
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<br /> � Yes,this section applies
<br /> The replacement of only one R�si�en�A fixt��or anpl'�.rCP that meets all three of the following
<br /> requirements:
<br /> 1. not require modi�ication W electrical or gas service.
<br /> 2. Has a total cost of$500.00 or 1ess;exc ' ti�e cost of the fixture or appliance:and
<br /> 3. Is improved,install�or replaced by the homoowner or licenszd plumbing contractor.
<br /> Skip next section,if this applies; Cost of Perniit S 15.00
<br /> State Surcharge $ 5.00
<br /> Mail-In Fce(If Applicable) � 2.00
<br /> Tots!Permit Fec $ 2 2 . 0 0
<br /> (Permlt Feea Continued On Nezt Yage)
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