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Fe6, 21, 2008 3:41 Fivl iVo rb 1 om Pl umb i ng No, 4941 P, 1/2 <br /> PLUMBTNG FIX'I'URES BEING INSTALLEJJ <br /> FIXTCIRE BSMT 1 2 O'Z'HER �T�TUk� SSMT ] 2` 01'H�R ' <br /> TYPE FT. �S, TYPE FL �'�, <br /> Water CloseY Floor Drains � <br /> Lavatory. Sewer Ejector <br /> Bathroom Laundry 1'zay <br /> Shower Washer • <br /> Kitchen Sink ViWater Y-leater � <br /> Disposal , �1Vater SoRener <br /> Dishwasher ��g�. , <br /> Sillcocks • � Miscellaneous <br /> • � <br /> . PERNITT FBE CALCTJLA`�TON(S)� � <br /> BASED OFF -2002 ST.�,TL STATU� ' � <br /> � Yes,i�,is sectzon applies <br /> The replsc�ment of a Residential fixtu or a�liance tt�at meers all three of�he following requirements: <br /> 1. Does not require modification Yo electricsl or gas service. <br /> 2. T�as a totai cost of$500.00 or less;exc udi the cost of the fxture or a�pliance:and <br /> 3. Is improved,installed o�r zeplaced by rlae hon�eowner or licensed contractor. <br /> Skip next section,iftbis app]ies; Cost ofpermit $ 15.00 <br /> �� State Surcharge $ .50 <br /> Mail-Tn Fee(If Applicable) S .50 <br /> '�ota1�er�nit�'ee � J?.00 <br /> (Permit�ees ConYqaued On Next Page) _ � <br /> 2 <br />