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FIXTURE BSMT 1 Z OTHER FIXTURE BSMT 1 2 N13 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet n Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub I I Laundry Tray ` <br /> Shower t Washer <br /> t <br /> Kitchen Sink Water Heater <br /> Disposal d. Water Softener <br /> Dishwasher l ' Wet Bar 1 <br /> Sillcocks ^ Miscellaneous 1 <br /> ,rte <br /> n <br /> f <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 total cost of$500.00 or less;excluding the cost of the fixture or appliance:and <br /> 3. Is irr proved,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) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Con ' ued On Next Page) <br /> 2 <br />