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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 t Floor Drains
<br /> !
<br /> Lavatory j Sewer Ejector
<br /> �
<br /> Bathtub Laundry Tray �
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<br /> ,� Shower W asher
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<br /> r-
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<br /> � Kitchen Sink '� Water Heater �
<br /> �'
<br /> t Disposal j Water Softener
<br /> � 4
<br /> �
<br /> ,.
<br /> � Dishwasher � Wet Bar
<br /> �
<br /> 4
<br /> ��� Sillcocks Miscellaneous
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<br /> 4
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<br /> PERMIT FEE CALCULATION(S)
<br /> BASED OFF - 20Q2 STATE STATUE
<br /> � ❑ Yes,this section applies
<br /> The replacement of a Residential fixture or appliance that meets all tluee of the following requirements
<br /> 1. Does not require modification to electrical or gas seivice.
<br /> 2. Has a total cost of$500.00 or less; excludin�the cost of the fixhzre or appliance: and
<br /> 3. Is improved, installed or replaced by the horneowner or 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 $
<br /> �$+. �}�'� ;� '� 3 �'���������§��W.� ,��!(� 1`� �N _ _ _ :.:,
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<br /> �r,fii a�,'t M � '�� r t.M��� `s'��` �R�z "'`� r �� �� � � �� ' ; i� ," k'-,'�a
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<br /> �y��r�,�, ����,�„ .� � ir• � '���-��. � : , t�'; �"{�.�v.x �.. �' �✓�y�.� t��,_:. ''e t� � "� ���� �€� 1., _:�.�" '�,yy,_ .
<br /> �, . _ ,� .,�y£` wt'".�������`� a' '�. �,�'' rr§r j„ T��'�, �s � " r e. �8 7, .t '`;�� ,� t -'` � g,� .
<br /> :�,�-f:'.-s.�.,. ,:.�rk.u.' �'�-ua..�' ��eF�"'r�?�t.. r�?�..,�+�.i:r-r2.�.�re¢-s�.r�..?�F;�.�.- .Y;c+�«&. .� .:Sa.� �:���..�,�za<�£` �� _.�,..
<br /> (Permit Fees Continued On Next Page)
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