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PLUMBING FI�CT[TftES BEING INSTALLED <br /> FIXTURE BSMT 1 2 OTEIER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains <br /> Iavatory Sewet Ejector <br /> Bathroom ���.5,T�y <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> PE�T�c�,cu�,�.�ox�s� <br /> BASED OF�-2002 STAT.E STATUE <br /> Yes,this section applies <br /> e replacement of a Residentiat fixture or a�nliance that meets all three of the following requirements: <br /> 1. Does not require mod�cation to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or ticensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> Sbte Swcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $�,o�- <br /> (Permit Fees Continued On Neat Page) <br /> 2 <br />