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PLUMBING FIXTURES BE1NG INSTALLED <br /> FIXTURE i BSMT IST 2�D � OTHER FIXTURE BSMT ls 2�D OTI-�R <br /> i TYPE I FL FL TYPE FL FL <br /> i <br /> Water Closet Floor Drains <br /> i Lavatory Sewer Ejector <br /> Bathroom i Laundry Tray <br /> Shower Washer ' <br /> Kitchen Sink Water Heater I <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF - 2002 STATE STATUE <br /> � Yes,this section appiies <br /> The replacement of a Residential fixture or ap�liance that meets all three of the following requirements: <br /> 1. Does not require modification to electrieal or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance:and <br /> �. .s imp:aved, ir,stalled cr rep;sc�d"y the ho::lec�vner or licensed;;ontracto:. <br /> Skip next section, if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Vlail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ l 9.DO <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />