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PLUMBING FT3�TURES BEING INSTALLED <br /> FIXTURE BSMT 1 2 OTI�R FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE P'L' '�L, <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathroom Laundry Tray <br /> Shower Washer <br /> Kitchen Sink � Water Heater <br /> Disposal Water Softener <br /> Dishwasher , Wet Bar <br /> Sillcocks Miscellaneous ^� <br /> 4� <br /> V <br /> ��S-fi�.�,,�r !� <br /> �"� I'����„�,�,y�� ��.-/,`,Y <br /> PERMIT FEE CALCULATION(S) <br /> BASED 0FF -2fl42 STATE STATUE <br /> � Yes,this section applies <br /> The replacement of a Residential fixture or apnliance that meets ali 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;excludin�the cost of the fi�cture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licens�contractor. <br /> Skip neat 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 /> t�as��t�'ar��Aur�ny�rd A°N�x����f) <br /> 2 <br />