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.I�,��.,n€ <br /> ,�� ;�r' - ' �� .�.... ._ <br /> s,.��� .� � � . �PLUI�IBING'FIXTURES BEING�INSTALL�;' � � <br /> FIXTURE BSM'i' 1 T 2ND OTHER FIXTURE BSMT l T 2"� OTHER <br /> T�'E 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 Neater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> � �� PERMIT HEE CALCULATIrON(S) <br /> �BASED OFF -�2002 STATE STATCTE <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 rcquire modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture or appliance: and <br /> ."s. Is improved,instaiied or replaced by tne nomeowner or licensed contractor. <br /> Skip next section,if this applies, Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee g��1.A� <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />