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Mat 29 1512:21 p Stewart Plumbing Inc. 763-428-1733 p.2 <br /> PLUMBING FIXTURES BEING INSTALLED <br /> FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet l 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 /> Sil lcocks Miscellaneous <br /> � 1 <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF- 2002 STATE STATUE <br /> p Yes,this section applies <br /> The replacement of only one Residential fixture or avpliance 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;excluding the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />