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From:763497�;263 02/23/2015 OB:52 #552 P.003/004 <br /> FIXTURE BSMT 1 2 OTF-�ER FIXTURE BSMT 1 2 OTHER <br /> T'YPE FL FL TYPE FL FL <br /> Water Closei � 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 /> ' s PER;� � A��AI.;CULAT�ION�S) - �� ,� <br /> y �: � a � � -'-�, �, <br /> � _ �:,s. <br /> ° fr-= - '.,,;�ASED Q�`E��-20Q2 STATE STATUEs _.` . yr..Y '� <br /> ❑ Yes,this section applies <br /> The replacement of only one Residential fixture or appliance that meets all three of the following <br /> requirements: <br /> l. Does not require modification to electrical or gas service. <br /> 2. Has a toial cost of$500.00 or less;excluding the cost of the fixture or appliance:and <br /> 3. Is improved,installed or repiaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(lf Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />