Laserfiche WebLink
. • ' <br /> ��•�:�,�v <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT l 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower W�� <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher W�g� <br /> Sillcocks Miscellaneous <br /> ❑ Yes,this section applies <br /> The replacement of only one Residenrial fixture or appliance that meets all three of the following <br /> requirements: <br /> 1. Dces not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin¢the cost of the fixture 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 S 22�� <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />