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PLUMBING FIXTURES BEING��iNSTALLED� � � <br /> FIXTURE BSMT 1 2�D OTHER FIXTURE BSMT 1 2� OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet 2 Floor Drains <br /> Lavatory 2 Sewer Ejector <br /> Bathroom Laundry Tray <br /> Shower 2 Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> �1`��-t�t.�'2S Su,p��l i eGt l�L� ht��l�,n�r <br /> PERMIT fi�;F CALCULAI'ION(S) <br /> HASF,D OFF - 2002 STAZ,F: SZ'ATUE <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;excluding 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) $ L50 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />