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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � � Floor Drains <br /> Lavatory � Sewer Ejector <br /> Bathroom � � Laundry Tray / <br /> =?r,��-��:1U <br /> Shower 1 Washer <br /> / <br /> Kitchen Sink Water Heater / <br /> Disposal / Water Softener <br /> Dishwasher Wet Bar <br /> � <br /> Sillcocks Miscellaneous j Lc Y-�1�•�,`� ��_ <br /> � i�lw Id�� <br /> Ox <br /> �`�; �F'I�,RI��I`I' E�Et� C'�i;CUIaA'I,101��(S) :� <br /> BASLD nl�I� '= 20(�2 STATE 5'I'A'1'UC <br /> ❑ Yes,this section applies <br /> The replacement of a Residenti 1 fixture or liance that meets all three of the following requirements: <br /> i <br /> 1. Does not require modificatj�n to electrical or gas service. <br /> 2. Has a total cost of$SOO.DO or less;excludin�the cost of the fixture or appliance: and <br /> 3. Is improved, installed:br replaced by the homeowner or licensed contractor. <br /> Skip next sectio ,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 />