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PLUNIBING FIXTURES BE1NG INSTALLED ' <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 Ej ector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater I <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> PERMIT FEE CAL,CUL�4TION(S) <br /> � � � BASED OFF - 2002 STATE STATUE � � <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 elechical 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 Pernut $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $j00 <br /> Total Permit Fee $�� <br /> l <br /> (Permit Fees Continued On 1\Text Page) <br /> � <br />