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� <br /> , <br /> . <br /> � <br /> . <br /> � .:�} {,,.� P�TI�BTN�f�F�XT�LT���.B�INC�7�INS"�AT,�.`�D �'`x� ;r� _�4o-, f 3L �,x,,_, <br /> �� . � �r�� <br /> FIXTURE BSMT 1 2 OTI�R FIXTURE BSMT 1 2 OTI-�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathroom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener � <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous � <br /> 2ra <br /> .�:�� ��, -.�rrr ar�-,����,���'���'�ta�'p'[� ,�1. f-" �� ��h�'��'���� ���t r'��` , ��'���`,4„�,��� `�',r F ��j, <br /> °j„��r����S ha�,����',�`,����� ���,f-�rr���,. � a^���^`�`F����r4��`+( �y��� ��y��{�t=�`,� '��1�„, r z �^'�l�z�� s- ��� }: <br /> 4 �'���� ��,� ��'µ�� 4�I��+.'!Y t:��'"���4���1i,�..-IJ���� YN'�:�" �jsF'�Fk'��.'�1�� ��: �n re �"' <br /> ����` 's;,;�x� pS �� , ,t�E� I,. ,i� tvt. F".�,' = a _:`+a <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or aualiance that rneets al1 three of the following reyuirements: <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 /> Skip 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 />