2012, 07-24 Permit App: BLD-2012-1178 Plumbing FixturePermit Center
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
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Plumbing Permit Application
SOokane 11707 E Sprague Ave, Suite 106
Valley
SITE ADDRESS: 5325 N Best
Mail or Fax To:
Norm's Excavating. Inc
PO Box 579
Veradale, WA 99037
Fax: 892-0432
1668 '°N
n Commercial
AVbb 8 6106 'WIN' ;wil p1AI DaN
PERMIT NUMBER: g td --1 a -
PERMIT FEE:
Residential
Building owner
DESCRIPTION OF WORK
# OF UNITS
Name: Mcpherson
Phone: 921-9737
Fax:
TOTAL AMOUNT
Address: SAME
City
State:
Zip:
Contractor
56.00
=
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: NORMSEI972BM
City Business License No:
Contact
X
36.00
Name: Sheila Gibbons
- Phone: 928-0580
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
AUTHORIZED SIGNATURE:
17.01 2E17026860S
2uneneox3 sw.JoN
REVISED t/2N05
e82:80 2T 42 inr
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
t
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
36.00
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
X
E6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREPICULINARY MEAT
X
56.00
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
$6.00
=
6
GARBAGE DISPOSAL
X
36.00
=
9
WATER SOFTENER
X
56.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
=
13
FOUNTAINS, DRINKING
X
50.00
=
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
56.00
=
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
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
320.00
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH D CHECK 0 VISA 0 MASTERCARD
Card# / EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
a00
TOTAL PERMIT FEE DUE:
14.00
AUTHORIZED SIGNATURE:
17.01 2E17026860S
2uneneox3 sw.JoN
REVISED t/2N05
e82:80 2T 42 inr