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_ . _. . .. .� <br /> ; � N ' ' �- : <br /> ,,. <br /> � , <br /> �� � _.: . _.�� . �� :: � � ��w� � �. <br /> FIXT'URE BSMT 1 2 OTf�R FIXTURE BSMT 1 2 OTf�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 Baz <br /> Sillcocks Miscellan�us 1 <br /> �,�Z �w� <br /> fi� � � � ; <br /> '� '*i9 � 4 y,-.�' � a� <br /> F�� �� ,��yf#���� � .; <br /> ;•xs a�� �3,4"�1�� Y t�'�i`r,,�� �� i <br /> .e .'W - !a . *trv i . ' " .ti=� <br /> ;..�... ..�:.r, . ._ .. �.r... , v� . ,. . �:. s t.,.`." au>_ <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�c�of$500.00 or less;excludin�the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeovme.r 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 /> Totai Permit Fee $ <br /> (Permit Fees Continued On Nezt Page) <br /> 2 <br />