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Y <br /> ♦ <br /> `' PLUMBING FIXTURES BEING INSTALLED. <br /> FIXTURE BSMT 1 2N� OTHER FIXTURE BSMT 15 2 OTHER <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 \�✓ater Heater ( <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscel]aneous <br /> ' PERMIT FEE CALCULATIOI�T(S) <br /> BASEI?OFF-2002 STATE STATUE, <br /> � Yes,this section applies <br /> The replaceme»t of only one Residential f;xture 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 total cost of$�00.00 or less;excludin�the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Sl:ip next section,ifthis applies; Cost ofPermit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee �.��1� <br /> (Perrn�ot�'ees Co�itia�ed Qn I�ekt P�ge) <br /> 2 <br />