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' ` ` PLTJIVIBII�'G.F.TXTLTRES BEThTG 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 Sof�ener <br /> Dishwasher Wet Bar � <br /> Sillcocks Miscellaneous <br /> . PERMTT�'EE C�I.CULAT��1�(�).� . , . � <br /> :BASED O�'F - �002 STATE`���TUE. <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; excludinQ the cost of the fixture or appliance: and <br /> 3.— Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next secrion,if this applies; Cost of Pernut $ 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 />