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PLUMBING FIXTURES BEING INSTAI,LED. �'. 5. <br /> FIXTURE BSMT 1 2Nv OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <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 f <br /> � <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> � � � � PERM�I'I'FEE�CALCULATION(S) �� � � �� � �� � � <br /> � � BAS.ED OFF�- 2002�STATE STA'I'U E � � ��� �� � <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;excluding the cost of the fi�cture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licen�ed contractor. <br /> Skip next 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 /> (Permit Fees Continued On Next Page) <br /> 2 <br />