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. � <br /> ' • , � <br /> PLUMBING FIXTURES BE1NG INSTALLED <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2' OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet j � Floor Drains / <br /> / <br /> Lavatory / � Sewer Ejector <br /> ( <br /> Bathtub i Laundry Tray � <br /> ! <br /> Shower � Washer � <br /> Kitchen Sink / Water Heater � <br /> Disposal � / Water Softener J <br /> ( ! <br /> . Dishwasher J Wet Bar <br /> ! <br /> Sillcocks � Miscellaneous <br /> PEP.1`,�IT FEE CALCULRTIQr:(S� <br /> BASED OFF - 2002 S'I'ATE STATUE <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; excludin�the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Pernut $ 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 />