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. <br /> PLUMBING FIXTURES BEING INSTALLED <br /> FIX�I�IJ[tl? t3SMT I�T 2ND OT�iER FIXTURE BSMT 1� 2�D OTHER <br /> TYP1; FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector � <br /> Bathtub Laundry Tray <br /> Sho�er 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 only one Residential fixture or appliance that meets all three of the following <br /> requircments: <br /> 1. Does not require modification to electrical or gas service. <br /> �. }�{as a total cost of$500.00 or less; excludin�the eost of the fixture or appliance: and <br /> ;. ls improvcd, installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section, if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ ��°����-' <br /> (Pcrniit Fecs Continucd On Next Page) <br /> 2 <br />