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� * <br /> � <br /> PLLTMBING FIXTURES BEING INSTALLED <br /> FI�iTURE BSMT ]' � 2' � OTHER FIXTURE BSMT 1' � 2' OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet S Floor Drains / <br /> � <br /> Lavatory � � � Sewer Ejector <br /> Bathtub 1 Laundry Tray � <br /> 1 <br /> Shower � Washer � <br /> Kitchen Sink � Water Heater � <br /> Disposal i Water Softener <br /> Dishwasher � Wet Bar � <br /> Sillcocks �� Miscellaneous <br /> ��� �PERMIT FEE CALCULATION(S) �, <br /> BASED OFF - 2002 STA?E 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; excludin�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 $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />