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� � <br /> ���. � ING F. `..� . <br /> �. <br /> �' � <br /> � , � � _ , � <br /> , , . <br /> �. .. , �, a,. , ��< < .<._ , � <br /> FIXT'URE BSMT I 2 OTHER FIXTURE BSMT 1 2 OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet � � Floor Drains <br /> r <br /> Lavatory , -, Sewer Ejector <br /> J � <br /> Bathroom � Laundry Tray <br /> 1 <br /> ( -'� <br /> Shower � Washer <br /> % <br /> Kitchen Sink Water Heater <br /> � � ! <br /> i <br /> Disposal � Water Softener <br /> Dishwasher Wet Bar <br /> ; <br /> Sillcocks --� Miscellaneous <br /> � <br /> � PERMIT FEE CALCULATION(S j � � <br /> BAS�ED OFF — 2002 STATP STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or apnliance 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;excludinQ 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 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 />