Laserfiche WebLink
PLLTMBING FIXTURES BEING INSTALLED <br /> FIXTURE BSM'I' I 2 OTHER FIXTiJRE BSMT 1 2 OTHER <br /> "CYPE FL FL TYPE FL FL <br /> Water Closet ^ � Floor Drains <br /> o� <br /> Lavatory � � Sewer Ejector <br /> Bathtub ' � I.aundry Tray I <br /> Shower I W asher i <br /> I <br /> Kitchen Sink I Water Heater ' <br /> Disposal t Water Softener <br /> � <br /> Dishwasher ` Wet Bar I <br /> 1 <br /> Sillcocks � Miscellaneous <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF- ?00? STATE STATUE <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 /> I. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ I 5.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />