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. �. . <br /> . <br /> \ <br /> 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 � Floor Drains <br /> Lavatory , , Sewer Ejector <br /> � 5 <br /> Bathroom Laundiy Tray <br /> 1 <br /> Shower � Washer <br /> 1 <br /> Kitchen Sink ; Water Heater i <br /> Disposal ` Water Softener <br /> Dishwasher Wet Bar <br /> � <br /> Sillcocks Miscellaneous <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF - 2002 STATE STATUE <br /> ❑ 1'es,this section applies <br /> The replacement of a Residential fixture or appliance that meets alt three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> ?. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance: and <br /> 3. ls 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 /> � <br />