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, � <br /> t <br /> PLliMBII�TG FIXTURES�EING INSTALLED <br /> FIXTURE BSMT 15� 2�D OTHER FIXTURE BSMT 15 2i'`� OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater ' <br /> Disposal ener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> � �� � � PERMIT FEE CALCULATION(S) �� � ��� � <br /> BASED OFF-2002�STATE STATUE� <br /> '� Yes;this section applies <br /> The replacement of only one Residential fixture or appliance that meets all three of the following <br /> requirements: <br /> l. Does not require modification to electrical or�as service. <br /> 2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Sl:ip 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 $�=vV <br /> (Perrniat F'ees Contir�ued On 1!'eat Page) <br /> 2 <br />