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'�""''�ryx,'�" ,�;,`, ,?�.,�fP��TMBINC�';FI�TLJRES BEII*TGriNS�ALL�A:`:;. ���.,,�.��r,,s; ":'�. <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Draips � <br /> Lavatory Sewe�Ejector <br /> Bathroom Laun�i�y Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> � <br /> Disposal Water Softener <br /> Dishwasher ' � Wet Bar <br /> Sillcocks , Miscellaneous <br /> ' P�RMIT FEE CALCULATION(S) ' ;' � ' :� � <br /> +; r,: r � <br /> �r . � �<� �, :,.s� ��� BASED OFF -�2002 STATE�STATUE �� � r���, ,. ., '' <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 electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excluding 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 Permit $ 15.00 <br /> � � State Surcharge $� <br /> � Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee , S�=L; <br /> � <br /> � <br /> (Permit Fees Continued On Ne�Page) <br /> 2 <br />