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, <br /> PLUMBING FITEES BEING NSTALLED.....,<. <br /> FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet 1 ,3 Floor Drains / <br /> Lavatory ( Sewer Ejector <br /> Bath y Laundry Tray V <br /> Shower Washer 1 <br /> Kitchen Sink Water Heater / <br /> Disposal i Water Softener <br /> Dishwasher / Wet Bar I <br /> Sillcocks a. Miscellaneous / <br /> PERMIT FEE C LCULATI`'N ) <br /> �iotellASE .F »2OO.2STt4 EST.STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all thr—olthe following requirements: <br /> 1. Does not require modificatio : - ectrical or 1 service. <br /> 2. Has a total cost of$500.00 or less;exc the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced e home. .er or licensed contractor. <br /> Skip next section,if this plies; Cost of Permit -•. $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />