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PLUMBING FIXTURES BE1NG INSTALLED <br /> FIXTURE BSMT 1��� �'`D OTHEIZ FIXI'UIZE BSMT 1�� 2�" OT1�ER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer ,� <br /> Kitchen Sink Water Heater ,� <br /> Disposal Water Softener ,� <br /> Dishwasher Wet Bar <br /> Sillcocks � Miscellaneous ,� <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF - 2002 STATE STATUE <br /> � Yes,this section applies <br /> The replacement of a Residential fixture ar appliance that meets all three of the following requirements: <br /> 1. � Does not require modification to electrical ar gas service. <br /> 2. �Has a total cost of$500.00 or less;excludin�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 $ 5.00 <br /> Mail-In Fee(]f Applicable) $ 2.00 <br /> Total Permit Fee $ �o.00 <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />