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Dec 171404:33p Stewart Plumbing Inc. 763-428-1733 p.3 <br /> PLU�VIBING FIXTURES BEING INSTALLED <br /> FIXTURE BSMT f ' 2 ° OTHER FIXTURE BST�iT 1 2" OTF�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � � Floor prains � <br /> I..avatory r� � ' Sewer Ejector <br /> 41 <br /> Bathtub Laundry Tray <br /> Shower I � V✓asher <br /> 1 <br /> Kitchen Sink Water Heater � <br /> Disposai 1Nater Softener <br /> Dishwasher , �Vet Bar � <br /> Sil lcocks Miscellaneous <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF -2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replaoemern of only one Residential fixture or appliance that meets all three of the following <br /> �cquiremenLs: <br /> i. Does not require modification to elecVical or gas service. <br /> 2. Has a wial aost of$500.00 or less;exciudi'n�;the cost ofthe fixture or appliance:and <br /> 3. Is improved,installed or seplaced by the homeowner or licensed plumbing oontractor. <br /> Sidp next section,if this applies; Cost of Permit $ �$,pp <br /> Scate Surcharge S 5.00 <br /> Mail-In Fee(lf Applicable) $ 2.d0 <br /> Total Permit Fee s <br /> (Permit Fees Continued On Next Page) <br /> 2 <br /> _ . r�a ,� <br />