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� <br /> i <br /> r , <br /> PLUMBING FIXTURES BEING INSTALLED <br /> FIXTURG [3SMT I�� 2�D OTI{ER FIXTURE BSMT I�� 2�" O�CIfER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathroom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater -� <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 applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of�500.00 or less;excludin�the cost of the fixture or appliance:and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit S 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) � 1.50 <br /> Total Permit Fee $ I��5"� <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />