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1 � <br /> . <br /> ... .� ,,. ,. . , <br /> � <br /> , , <br /> �^�." <br /> E..�� � .� , � � <br /> ,ti. � �, .. ,� � , <br /> s. ,. �.�, � .,�. � r. ,. <br /> 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 /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> � <br /> , ; �Z� y�� <br /> r � �h�����. <br /> oS <br /> � � � PERMIT FEE CALCULATION(S) � � � <br /> BASED OFF - 2002 STATE STATtTE <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;excludine 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-ln Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />