HomeMy WebLinkAbout2011, 10-04 Permit Application: 11003118 Bldg Drain ConnectPermit Center
SpOl ane 11707 E Sprague Ave, Suite 106
.6000 Val d , Spokane Valley, WA 99206
Vl le 3 (509)688 -0036 FAX: (509)688 -0037
omnwnity Development (...,
lumbing Permit Application :
Mail or Fax To:
Norm's Excavating, Inc
PO Box 574
Veradale, WA 99037
Fax: 892 -0432
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PERMIT NUMBER: i1'31t
PERMIT FEE:
n Commercial ® Residential
1TE ADDRESS: 14323 E Alki
i
Building owner
X
COST
Name: Potts
Phone: 924 -2784
Fax:
Address: SAME
City: State:
Zip:
Contractor
$6.00
=
Name: Norm's Excavating, Inc
Phone: 509/928 -0580
Fax: 509/892 -0432
Address: PO Box 574
City : Veradale State: WA
Zip: 99037
License No: NORMSE1972BM
City Business License No:
Contact
TUBS
Name: Sheila Gibbons
Phone: 928 -0580
$6.00
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
X
56.00
=
5
SINKS
LAVS /BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
X
56.00
=
6
DISHWASHER
X
56.00
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
=
12
ROOF DRAINS /OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING /DRAIN -IN WASTE,
VENT. PLUMBING, REVERSAL
NSTALIATION, ALTERATION, REPAIR,
REVERSALS
1
X
$6.00
=
6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN /OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAL/SYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
1
X
515.00
=
METHOD OF PAYMENT: 1
❑ CHECK ® VISA ❑ MASTERCARD
SUBTOTAL
6.00
PROCESSING FEE
❑ CASH
Car& Cover Sheet SIRES:
(
TOTAL PERMIT FEE DUE:
6.00
See
I
AUTHORIZED SIGNATURE: REVISED S /26 /05