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Stewart Plumbing, Inc. 7634281733 p.2 <br /> . ' <br /> PLUMBING FIXTURE� BEING IN5TALLED <br /> FIXTURE BSMT l 2 OTHER PIXTLTRE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet I � Floor Drains <br /> La��atory � � Sewer Ejector <br /> Bathtub � Iaundry Tray � <br /> Shower � Washer <br /> Kitch�Sink Water Heater � <br /> i <br /> Disposal Water 3oftener <br /> � <br /> Dishvvasher Wct Bar i <br /> Sillcocks Miscellaneous <br /> PERMIT FEE CALCULATION(5) <br /> BASED OFF-2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of only one Residentiai fixture or analiance that meets all three of the following <br /> requirements: ' <br /> l. Dces not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excl in the cost of the fix#ure or appliance:and <br /> 3. Is improved,installed or replaced by tt►e horneowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Pem�►it $ 15.00 <br /> State Surcharge $ 1.00 <br /> Mail-In Fee(If Applicabie) $ 2.00 <br /> Totat Permit Fee � <br /> (Permit Fees Cantinued On Next Page) <br /> 2 <br />