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'+., <br /> , <br /> PLUMBIN�G�FIXTLTRES BEING INSTALLED �� �� �"';�"����"��`����� <br /> �� .�. � <br /> FIXTURE BSMT 1' 2 OTHER FIXTURE BSMT 1' 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � Floor Drains <br /> Lavatory / Sewer Ejector <br /> 5� <br /> Bathtub Laundry Tray �� <br /> Z <br /> Shower Z J Washer <br /> / <br /> Kitchen Sink Water Heater � <br /> 2�- <br /> Disposal Z Water Softener j <br /> J <br /> Dishwasher � Wet Bar <br /> Sillcocks Miscellaneous <br /> �--'v�:� ���7� ,�-.�-�--z' ��"'`�c �--, �.tJ cr-9 � <br /> j PERMIT FEE CALCULATION(S) --�--1 <br /> BASED OFF - 2002 STATE STATUE i <br /> ❑ Yes, this section applies <br /> The replacement of a Residential fixture or a� liance that meets all three of the following requirements: <br /> 1. Does not require 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 /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section, if this applies; Cost of Pernut $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />