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_PLUMBING FIXTURES BEING INSTALLED <br /> FIXTURE BSMT 1�'� ��r' OTHER FIXTURE BSMT ]s� 2'D OTHER <br /> TYPF FL FL TYPF, FL FL <br /> Water Closet Floor Drains <br /> � Lavatory <br /> Sewer Ejector <br /> Bathtub Lnundry Tray <br /> �---- -- --__ <br /> --- -- <br /> ____-- <br /> hawcr Washer - <br /> Kitchen Sink Water Heater � <br /> � Disposal Water Softener <br /> � Dishwasher Wet Bar <br /> I <br /> � Sillcocks Miscellaneous <br /> I <br /> � PERMIT FEE CALCULATION(S) <br /> BASED OFF - 2002 STATE STATUE <br /> ❑ Ycs, this scction applics <br /> The replacement of unly une Residential fixtw-e or appli�nce that meets all three of the following <br /> requirements: <br /> 1. Does not require modification to electrical or gas seivice. <br /> 2. Has a total cust of�500.Op ur�ess;excludine the cost of the tixturc or appliance: and <br /> 3. Is improved, installed or r-eplaced by the homeowner or licensed plumbing contractor. <br /> Skip ncxt scction, if this applics; Cost of Pcrmit S 15.00 <br /> Statc Surcllargc S 5.00 <br /> ;�1ail-In Fee(If Applicab(e) S 2.00 <br /> Total Permit Fee �__,���L,r� <br /> (Permit Fees Cuntinued On Next Page) <br /> 2 <br />