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e �SS� .r � � '� �^r �7��/'��'J'�7 '�+'�'� t s � �j; `ro`�L.�c,-�s �� <br /> 'v."a�'��k"Y�i,,si.w�'+...��t`�,ro,.:� r 9 PJ.+��t7�� ,,�:.�..�� ���J.�LYI.�,I"1L�1����-fk.���,,,�T�:"rs o- ,1:�r:� � uJ $,�i�su..;; <br /> t': <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OT'HER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Z 1 � Floor Drains Z � �, <br /> ( <br /> Lavatory 2 1 � Sewer Bjector � G � <br /> 1 <br /> Bathtub � � � Laundry Tray � 0 � <br /> Shower � � � Washer � d � <br /> Kitchen Sink O � � Water Heater � 0 � <br /> Disposal � � p Water Softener / d b <br /> Dishwasher b Wet Bar e � � <br /> i � <br /> Sillcocks � -L � Miscellaneous o v � <br /> �� <br /> +'c.c`�` . , �i. �y,��.,,�,yu ..,f� t 1 ':. 'G �'}c � :. "���, � F��; ,"Mr a�- ��w�.�r �� ��a i� <br /> ,��,R§•I I '?r.Y/' '6 � i>, <br /> �,��e ��-.��'� ��� �� ;� � �p � i'��.�a � .�n �'� ,:Na� a sy� �� ��'�y,��M� d ,� C 5 �� rc�a���`'�; <br /> ���"`.;� ,& <«° , . �" �1��J�(��'�"�`A,�?`�arT�.�����,�` ' ���`���� ����vkp�� <br /> �h� p,�.t' v. �,.., '� a �:�71:,u{� .s,, - 'v , .i`-�.. i, . �., � . �-.,�r a.'�' P `� '�'r 3'�.h$°i <br /> ❑ Yes,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;excludin�the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Slcip 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 />