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� <br /> ! <br /> � ; , .. PLUMBING FIXTURES BEING IN�'i'AI.L�D - <br /> FIXTURE BSMT 1 2 IOTHER FIXTURE BSMT' FL FL OT�R <br /> TYFE FL FL a 'I'YPE ' <br /> 1 <br /> , Water Claset Floor Drains <br /> Lavatary Sewer Ejector <br /> Bathroom Laundry Tray � <br /> �Shower { ` i Washer <br /> ____.� � 1 <br /> Kitl chen Sink ^ � Water Heater , <br /> � ( <br /> Disposa! �. 1�'ater Softener { � ' <br /> Dishwasher , W'et Bar j <br /> i <br /> Sillcocks Miscetlaneous � <br /> � � :�ERL'vIIT F£E CALCU�.ATIUN(S) ,:� � <br /> u . <br /> � <br /> � � BAS£D OF� -20Q2 STATE STATUE . . . `� . . '�: � �:'.� <br /> � Yes,this section applies <br /> The replacement of a Rp���P^t��l fixture or aonliance that meets all three of the foilowing requieemenu: <br /> l, gges►ot reqaire modification ta elecvical or gas service. <br /> 2. Has a tutal cost of$500.0�or less;excludin�the cost of the t'ixture or apptiance: astid <br /> 3. Is improved,installed ar replaced by the hameowner or licensed contracwr. <br /> Skip next section,if this applies; Cost of Permit $ 1�.Ofl <br /> State Surcharge � •SQ <br /> Mail•In Fet{IfApplicable) S 1,54 <br /> Total Fermtt Fee � '� � <br /> (P�rmif�ees Continued On Next Page) _ <br /> � <br />