Laserfiche WebLink
PLUMBING FI�TURES BEING INSTALLED <br /> FIXTURE BSMT 1 2 ' OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Z 1 Floor Drains <br /> Lavatory 2 Z Sewer Ejector <br /> Bathtub , Laundry Tray i � <br /> Shower Z Washer ' , <br /> Kitchen Sink � Water Heater <br /> Disposal � Water 5oftener <br /> Dishwasher Z Wet Bar 1 <br /> Sillcocks Miscellaneous <br /> PERMIT FEE CALCULATION(S) <br /> BA�ED OFF-2002 STATE STATLTE <br /> ❑ Yes,this section applies <br /> The replacement of only one Residential fixhu�e or appliance that meets all three of the following <br /> requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;exdudine the cost of the tixture or appliance: and <br /> 3. Ts improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />