Laserfiche WebLink
T <br /> PI.,UMBINC FIXTU�tES BFiNG INSTALLED <br /> FIXTURE [3SMT �s�r ZNo p'I'HER FIX"I�URE BSMT 1ST �ND OTHER <br /> TYPE F[, 1'l, "IYPE }�L FL <br /> Water Closet ( Floor Drains <br /> Lavatory ^ Sewer Ejector <br /> e• <br /> Bathtub � L,aundry Tray <br /> Shower i Washer <br /> � <br /> Kitchen S�ilc Water Heater <br /> Disposal Water Sof�ener <br /> Dishwasher Wet Bar <br /> S ilkocks M isce llaneous <br /> I PERMIT FEE CALCULAT[ON(S} <br /> �_ BASED OFF 2002 STAT'E STATUE <br /> ❑ Yes,this section applies <br /> The replacement ofonly one Residential fi�ime or a�pliance tl�at meets all three ofthe following <br /> requirements: <br /> 1. Does not requffe modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;exclud'm�the cost ofthe fxl�n•e or appliance:and <br /> 3. [s nnproved, mstalled or replaced by the homeowner or licensed plwnbing contractor. <br /> Skip neact section, ifthis applies; Cost ofPermit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-ln Fee(IfApplicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />