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� <br /> � � �ti:. <br /> . . <br /> �^� ���. �,�: �� :�.� <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 /> Bathroom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> �i��i�t�� �f Cl�f.tl�h� �jf�'ci��?� � �,�,✓v� �VY�c�cti�P�ln S�S��,N. . <br /> �f(,���-er .:,��I.ISD_c��0 <br /> PERMIT FEE CALCULATIQN(S}��� � <br /> BASED�OFF-?A02 STATE STATU�� � <br /> � Yes,this section applies <br /> The replacement of a Residential fixture or apvliance that meets all three of the following requirements: <br /> 1. Does not require modification to electricai or gas service. <br /> 2. Has a total cost of$500.00 or less;excludins 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 $ I5.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ � •GD <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />