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<br /> FIXTUR� ; BSMT 1 2 OTHER FIXTURE �SMT i 2 OTHER
<br /> TYPE FL FL TYPE FL FL
<br /> Water Clo t' �j/_ � � F1oar Drains
<br /> o..
<br /> Lavatory � j �2 � Sewer Ejector
<br /> � � d
<br /> Bathtub ; Laundry Tray
<br /> � 1 � .
<br /> Shower � Washer
<br /> 1 �
<br /> Kitchen S" Water Heater
<br /> �
<br /> Disposal , Water Softener
<br /> Dishwash ` Wet Bar: :
<br /> Sillcocks , ; Ivlisceilaneous
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<br /> � � 1.�'�� J � �i �.<•� ��� � *a+�* Fs'"` ^P �'� `��t �^��'�'� �e- S �ir�,�3'
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<br /> ❑ Yes tl�is section applies
<br /> 1
<br /> The replace en�of.a R�sidential fixture or appli�nce tbat meets all three of the following iequi�rements:
<br /> :� -
<br /> ' 1. _, es not require modification to electrical or gas seryice.
<br /> 2. , a tota_ l�ost of$500.00 or less;exctudine the cost of the fixture or appliance:and
<br /> 3. ; 's roved,installed or replacedby the homeowner or licens�d.contaacior. :
<br /> , ,.
<br /> ' ; p next secrion,if this applies; Cost of Permit . $ 15.00
<br /> { i � State 6urcharge $ ,Sp
<br /> . .. . __ . _.._._ .__ '.. ...,...: ._, ,..._ .__. ..__ ___ �;..-- -- -�v1a�:InFee(I€Appli�able).__ .--- _$.: . --T:50 ____-- –
<br /> , TotaT Permit Fee $
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<br /> (Permit Fees o�ntinued On Next Page)
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