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* <br /> ' , , , <br /> �.., PL�[TMBING,FIXTURES_BEING,INSTALLED=; <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains / <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Siilcocks Miscellaneous <br /> ,� }" 'n PERMIT,FEE CALCIJLA'I'IfJN S : <br /> - , ( ), , � , �_ <br /> �" � << n 7,. ,, . <br /> ` � ., , .. .. ; .� . � " � <br /> {BASET� OFF 2002 STATE STATLIE , ' <br /> ❑ Yes,this section applies , <br /> The replacement of a Residential fixture or a�pliance that meets all tluee of the following requirements: <br /> 1. Does not require modification to elechical or gas service. <br /> 2. Has a total cost of$500.00 or less;excluding the cost of the fixiure or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed conh•actor. <br /> Skip next section, if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee � <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />