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, • . <br /> , <br /> PLUMBING FIXTURES BE1NG INSTALLEI3 <br /> FIXTURE BSMT 1 2�D OTHER FI�TURE 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 Sinh Water Heater � <br /> Disposal Water Sofrener <br /> Dishwasher Wet Bar <br /> Sil lcocks Miscellaneous <br /> PER.MIT FEE CAI:.GULA'I'IOI�T.{.S) <br /> BASED OFF-2002 STATE STATUE. <br /> � Yes,this section applies <br /> The replacement of only one Residential fta�ture or appliance that meets all three of the followin� <br /> requirements: <br /> i. 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 fiature or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Sl;ip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-Tn Fee(if Applicable) $ 2.00 <br /> Total Permit�ee $ Z2,UJ <br /> (�er�m4�ees Co�itir�ued�3n Idext�'��e) <br /> 2 <br />