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�_ PLUMBING FIXTURES BEING INSTALLED _ J <br /> i FIX7URE BSM'r 1�� 2ND OTHE;R � FIXTURE�BSMT 1'� "D <br /> i TYPF, FL FL 2' OTHER <br /> TYPF. FL FL <br /> � Water Closet Floor Drains <br /> � Lavatory Sewer Ejector <br /> ! Bathtub Laundry Tray <br /> iShower -— -- Washer —. — <br /> Kitchen Sink - ��;r�r uo ,o� <br /> j Disposal � <br /> Water Softener <br /> ! Dishwasher <br /> Wet Bar <br /> '� Sillcocks <br /> Miscellancous <br /> ------ L----�-- <br /> � PERMIT FEE CALCULATION(S) <br /> �--- BASED OFF 2002 �TqTE STATUE <br /> ❑ Ycs, khis scction applies <br /> The replacemen[of only one Residential tixture or a� liance that meets all three of the followin�r <br /> requ�rements: <br /> 1. Does not require modification to elec4-icai or gas service. <br /> 2. Has a totai cost of$SOO.GO ur]css; cxc]___udinb the cost of thc fixturc or appliancc: and <br /> 3• 1s improved, installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip ncxt section, if this applics Cost of Permit <br /> State Surchargc � ��00 <br /> Nlail-[n Fee(If Applicable $ ��0 <br /> Tutal Permit Fee � $ ,���00 <br /> �� <br /> (Permit Fees Continued On Next Pabc) <br /> 2 <br />