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'"..Pi;LT.NiB�G�FTXT''CJXZE�BEII�'Cr��Il�1=STA`L,I��7j:,, , =° Fy _'. , <br /> FIXTiJRE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejectar <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater � <br /> Disposal Water Softener <br /> Dishwasher Wet Baz <br /> Sillcocks Miscellaneous <br /> a S f.i f �^1�����M C.�T ,..: ���� !�/j�•� , 4; 'fi� c • .y. t c <br /> ) u ; <br /> , '� ,� .; `" ..;::��l:r,.�'.�� Q�, ��Q�.��:t�.,��r��� K; � . �„": s �,,��� <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or ap liance that meets all three of the following requirements: <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 section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> _ _ . _ _ __ -- _._ _ ___. _._ .._.. . _ __. . _. _.__.. _-Ma�-In Fee(If-Applicable) _ _.$ - -1.50 -_ <br /> __ _ _ <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br /> , ', ' . � <br />