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� <br /> � <br /> � PLUMI3ING FIXTURES BEII�G INSTALLED _ <br /> FIXTUR� BSMT 1 2' OTHER FIXTURE BS'_VIT 1' 2 OTHER <br /> TYPE FL PL TYPL' FL PL <br /> Water Closet Floor Drains <br /> Lavatory Se�;�er Ejector <br /> Bathhib LaLmdry Tray <br /> Shower Washer <br /> ICitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasller Wet Bar <br /> Sillcocks �i�scellaneous � <br /> � <br /> ����� <br /> �� � e� <br /> 1 <br /> PF,RMIT FEE CALCUL�ITION(S) <br /> BASED OFT - 2002 STATL STATUE <br /> ❑ Yes, this section applies <br /> The replaceinent of a Residential fihhire or appliance that meets all tlu•ee of�the follo�ving requirements: <br /> 1. Does not requize modification to eleehical or�as service. <br /> 2. Has a total cost of$500.00 or less; excluding the cost of the �('ixture or appliai�ce: and <br /> 3. Is improved, installed oi•replaced by the homeo��ner or licensed eontractor. <br /> S]<ip nest section, if this applies; Cost of Perrnit $ 15.00 <br /> State Stu�charge S .�0 <br /> Mail-In Fee (If Applicable) $ 1.50 <br /> �'otal Pere�iit Fee � <br /> (1'erenit Fees Continued On Next Page) <br /> � <br />