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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 /> l <br /> Bathroom Laundry Tray <br /> Shower J Washer <br /> l <br /> Kitchen Sink Water Heater <br /> /; <br /> Disposal Water Softener <br /> Dishwasher / Wet Baz <br /> � <br /> Sillcocks Miscellaneous <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or annliance 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;excludine the cost of the fi�cture 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 Surchazge $ .50 <br /> • Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />