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I � <br /> . � <br /> � � � � � PLUMBING FIXTURES BEING INSTALLED� �� � � � <br /> � FIXTURE BSMT 1'' 2"�° OTHER FIXTliRE BSMT 15 2�1D OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower W asher <br /> _ � i <br /> Kitchen Sinh Water Heater � <br /> Disposal ��l�ater Softener <br /> Dishwasher Wet Bar <br /> Sillcock� Miscellaneous <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF-?002 STATE STATUE <br /> � Yes,this;ection applies <br /> The replacement of only one Residential fixture or appliance that meets all three of the followin� <br /> requ irements: <br /> 1. Does not require modification to electrical or�as service. <br /> 2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture or appliance:and <br /> 3. Is impioved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Slcip next section,ifthis applies; Cost of Permit $ 15.00 <br /> State Surcharee $ 5.00 <br /> Mail-in Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ c�c� a� <br /> (d'errr�i4�ees Contine�ed On Next Page) <br /> 2 <br />