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� <br /> ��` �;�'��� ``���� �° PI.;UMBING FIXTURES BE1NG INSTALL,ED <br /> � ��v <br /> FIXTURE BSMT 1 2�D OTHER FIXTURE BSMT 1" 2�D OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> 2 z <br /> Lavatory Sewer Ejector <br /> Bathroom Laundry Tray <br /> � / <br /> Shower Washer <br /> / <br /> Kitchen Sink Water Heater <br /> � <br /> Disposal r Water Softener <br /> Dishwasher Wet Bar <br /> � � <br /> Sillcocks � Miscellaneous <br /> � � � � �� PERMIT FEE CALCULATION(S) � <br /> . BASED OFF - 2002 STATE STATUC <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;excludine 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 $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />