2012, 10-24 Permit App: BLD-2012-1914 Plumbing Fixturessp. '
��alley
Community Development
Plumbing Permit
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
www.spokanevalley.org,.com
Application
Mail or Fax To:
Norm's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892 -0432
p.2
6Z0- Zen if I
PERMIT NUMBER:
PERMIT FEE: AS' 4/3 -40
❑ Commercial ® Residential
SITE ADDRESS:
17926 E Alki
Building owner
DESCRIPTION OF WORK
Name: Anderson
Phone: 893 -3990
Fax:
Address: SAME
City: State:
Zip:
Contractor
WATER CLOSET, BIDETS
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:
X
Contact
=
Name: Sheila Gibbons
Phone: 928 -0580
AUTHORIZED SIGNATURE:
et-
Received Time Oct. 24. 2012 12:29PM No.0662
REVISED 8/26/05
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
S6.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
B
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56.00
=
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
NSTALLATION, ALTERATION. REPAIR,
REVERSALS
1
X
56.00
=
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
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS. BOILERS
X
56.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
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
X
$15.00
=
METHOD OF PAYMENT:
0 CASH ❑ CHECK ® VISA 0 MASTERCARD
Card* On fax cover sheet EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
37.00
TOTAL PERMIT FEE DUE:
43.00
AUTHORIZED SIGNATURE:
et-
Received Time Oct. 24. 2012 12:29PM No.0662
REVISED 8/26/05