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Oct 30 12 02:15p Stewart Plumbing Inc. 763-428-1733 p.3 <br /> PLLTMBING FIXTURES BETNG IN5�'ALLED <br /> FIXTiTRE BSMT 1 2 OTHF.R PIXTURF. $SM"T 1 2� OTI-IER <br /> TYPE FL FI. TYPE Fl. FL <br /> Water Closoi � � I I�7oor Ihains � <br /> Lavatory � � � Sewer Ejector <br /> Rathtub ( I Laundry Tray <br /> Sl�ower � I W�sher � i <br /> � <br /> Kitchen Sinl: � Water�Ieatcr � <br /> Disposal I Water Softener <br /> Dishwasher ' ` Wet Bar <br /> Sillcocks � Miscellaneous <br /> PERMIT FEE CALCLTLA�'ION(S) <br /> BASED OFF- 2002 STATE STATUE <br /> ❑ Yes,tlus section applies <br /> The replacement o r only�one Rcsidential fixture or a,�liance that meets all three of the follo�ving <br /> re c{uiremen[s: <br /> l_ Does not reqwre modification ta electrical or gas service_ <br /> Z. Has a toial cost of$500_00 ar Iess;excludinQ thc cost af the fixture or appliance:and <br /> 3. Is impro�ed,insfalicd or replaced by the homeo�rner or licensed plumbing contractor_ <br /> Skip next sec�on,if this applies; Cost oFPermit $ 15.00 <br /> State Surchar�e $ 5.00 <br /> Mail-In Fee (If Applicable) $ ?.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Ncxt Pagej <br /> 2 <br />