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r <br /> PLUNiBING FIXTURES BEING INSTALLED , ' <br /> FIXTURE BSMT ls 2 OTHER FIXTURE BSMT 1 2'�1D O'THER <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 CALCUI,AT�ON(S) <br /> BASED OFF - 2002 S'I'ATE STATIJE <br /> Yes,this section applies <br /> The re lacement of only one Residential fixture or appliance that meets all three of the following <br /> requirements <br /> 1. Does not require mc�ifieation te electr.cal or gas sen�ice. <br /> 2. Has a totai cost of$500.00 or less;cxcludin�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 $ 15.�0 <br /> State Surcharge $�� <br /> Mail-In Fee(If Applicable) $ UO <br /> Total Permit Fee $����� <br /> ,.. <br /> (Permit Fees Continued On Next Page) <br /> . _ . � 2 <br /> . , . <br />