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. �' � , <br /> � � ' '"�' �F : Ty P�.�.°[1MBING FIXTURES B°. � �� � <br /> ��.. � ��.� • � . ��. �,� �.� i ">' ' °� ,:,.,r _„, ���� <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 /> 1 <br /> Lavatory � � Sewer Ejector <br /> Bathroom i Laundry Tray ' � ' <br /> Shower Washer ' <br /> Kitchen Sink � � Water Heater <br /> Disposal � Water Softener <br /> Dishwasher � Wet Bar <br /> Sillcocks Z Miscellaneous <br /> PERMIT FI;E CALCULATION(S) � <br /> BASED OFF - 2002 STATE STATU�E <br /> ❑ Yes,this section applies <br /> The repiacement of a Residential fixture or apnliance 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 />