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00 <br /> 6 ` * = g PK BIXTA TUBESS'BE NG:JNSTAttED '... 1 <br /> FIXTURE BSMT 1" 2ND OTHER FIXTURE BSMT 1" 2ND OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous L. <br /> .� � �l' ,,43rd., � � � �.�✓ � Ke�.�"'�3,+- � �,�"� ;� y, bra 5,+.f�r es3A�,�r�ii <br /> �,� ,,, "ut '•r 9 k�tS'"'��' p YD �^"��a�y, e 'b�:: InS � . ;�-S,d €""�.�T{n��a ^'�'.„_Td <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;excluding 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 $ K.c 0 <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />