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PLUMBING FIXTURES BEING INSTALLED <br /> FIXTURE BSMT� t'� 2"D OTHER I=IX"I�URE BSM"I 1'� 2`�' OTHER <br /> TYPF. FL FL TYPF, 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 Miscellancous <br /> �� � PERMIT FEE CALCULATION(S) i <br /> BASED OFF - 2002 STATE STATUE �I <br /> ❑ Yes,this section applics <br /> The replacement of unlv one Residential tixCure or anpliance that meets all three of the following <br /> requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less, excludin�the cost of the fixture or appliance: and <br /> 3. [s improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Pcnnit $ 15.00 <br /> Statc Surcharge � 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $V�,�7`'`�' <br /> (Permit Fees Cuntinued On Next Page) <br /> 2 <br />