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` � • � <br /> PLUMBING FIXTURES BEING 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 Ejector <br /> Bathtub � Laundry Tray <br /> Shower r Washer r <br /> � <br /> Kitchen Sink � Water Heater <br /> Disposal ( Water Softener <br /> Dishwasher i Wet Bar <br /> Sillcocks i cellaneou� I <br /> u� ice mal�z� <br /> - PERMIT FEE CALCULATION(S) <br /> BASED OFF - 2002 STATE STATUE <br /> �, Yes, this section applies <br /> The replacement of a Residential fixture or appliance that meets all tlu�ee of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less; exclud' s f the fixture or appliance: and <br /> 3. Is improved, installed or replaced b e homeowner r licensed contractor. <br /> Skip next section, if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ �'1. � <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />