Laserfiche WebLink
� <br /> PLUMBING FIXTURES BEING INSTALLED <br /> FIXTLJRE BSMT IST 21'1D OTHER FIXTURE BSMT 1ST 2T'1D OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � Floor Drains <br /> I,avatory Sewer Ejector <br /> � <br /> Bathtub Laundry Tray <br /> � <br /> Shower Washer <br /> � <br /> Kitchen Sink I Water Heater <br /> Disposal t 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 annliance that meets all three of the following <br /> requirements: <br /> 1. Dces not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surchazge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Negt Page) <br /> 2 <br />