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PLUMBING FIXTURES BEING INSTALLED <br /> FiXT'iJRF. BSMT 1` 2 O'I�tIF:R FIXTiTRF. RSMT 1 2 OTHF,R <br /> 1 YPL 1'L 1�L 1 YYL 1�L 1'L <br /> Water Closet Floor Thains <br /> Lavatorv Scwcr Ejector <br /> I3athroom Laundrv lrav <br /> Sho�ver Washer <br /> Kitchen Sink / Water IIeater <br /> Disposal Water Softener <br /> Dish�vasher Wet Rar <br /> Sillcocks Miscellaneous <br /> � <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFE - 20O2 STATE STATUE <br /> Yes,this section applies <br /> The replacement of a Residential fia-ture or appliance that meets all three of the tollo��ing requirements: <br /> 1. Does not require modification lo electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;e�cludin�the cost of the fi�ture or appliance:and <br /> _'s. Is unproved;inst�211ed or replaced by the homeo��ner or licensed contractor. <br /> Skip neart secrion,if this applies; Cost of Pennit $ I 5.00 <br /> St1te Surcharge $ 50 <br /> Mail-1nPee(If Applicablej $ 1.50 <br /> I i�- Total Pcrmit Fcc S�Q� <br /> I I. <br /> , i . <br /> ,, <br /> � I'�, I', <br /> (Permit Fces Continucd On Nest Pa�c) <br /> 2 <br /> ' ji <br /> !R <br /> � i �� <br />