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/ <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 /> , � <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Ttay <br /> Shower Washer <br /> Kitchen Sink Water Heater � <br /> v <br /> Disposal Water Softener j <br /> � �� <br /> Dishwasher Wet Baz <br /> Sillcocks , Miscellaneous <br /> � ���.PERMIT FEE CAL�LTLATiQN(S) ;- ;.� �� <br /> - �' BASED OFF'-2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance 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;excludina 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 Permit $ 15.Q0 <br /> ' . State Surcharge $ 5.00 <br /> � Mail-In Fee(If Applicable� $41,,;� . <br /> � Total Permit Fee � $ , <br /> � -. <br /> ' � .� <br /> � <br /> (Permit Fees Continued On Next Page� <br /> . <br /> 2 <br /> � <br />