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. � <br /> PLU1vIBING FIXTURES BEII�G II�tSTALLED; � ;' <br /> FIX RE BSMT 1 2�` OTHER FIXTURE BSMT 1 2 OT ER <br /> TZ'P� FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathti�b Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar ' <br /> Si]icocks • Miscellaneous <br /> :� "PERMI'T�EE CALCU�,AT'ION(.S) <br /> ,, <br /> BASED OFF-;2002 STATE ST�TUE.. :: <br /> � Yes,this section applies <br /> The replacement of on6y one Residential ftarture or a�pliance that meets all three of the followin,; <br /> requiraments: <br /> l. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and <br /> 3. (s improved,installed or replaced by the homeowner or licensed plumbin�contractor. <br /> � Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 ' <br /> 7'otal Perntit 1�ee $��! <br /> (Perrt�it�ees Cootti��ed�n I'�Iext P��e) <br /> 2 <br />