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• <br /> , R. , <br /> PLUMBING FIXTURES BE1NG INSTALLED <br /> FIXTURE BSATT 1sT 2�'° OTHER FIXTURE BSMT 1ST 2ND OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor D rains <br /> Lavatory Sewer Ejector <br /> Batbtub Luundry Tra.y <br /> Shower 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 /> requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludina the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner oi•licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surchar�e $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> T«tai Parmi#Fc:�� � a2.00 <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />