2012, 10-02 Permit App: BLD-2012-1716 Plumbing FixtureOct 02 12 10:14a
Norms Excavating
Permit Center
Spokane 11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www._spok:inevallev.or_ corn
Plumbing Permit Application ❑
1 U lley
5098920432
Mail or Fax To:
Norms Excavating, Inc.
PO Box 574
Veradale, WA99037
Fax: 892-0432
P.5
PERMIT NUMBER: 43 1z _
PERMIT FEE: / Y O1
Commercial Z Residential
)714
SITE ADDRESS: _4318 N Best
Building owner
DESCRIPTION OF WORK
Name: Drake
Phone: 926-9045 Fax:
COST
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: NOR,MSEI972BM
City Business License No:
X
Contact
Name: Sheila Gibbons
Phone: 928-0580
AUTHORIZED SIGNATURE:
i;
Received Time Oct. 2. 2012 10:27AM No. 0186
REVISED 9/26'05
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
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
56.00
=
8
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
36.00
12
ROOF DRAINS/OVERFLOW
DRAINS
X
36.00
=
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
58.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$8.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS. TANKS, BOILERS
X
36.00
=
18
INTERCEPTORS
GREASE TRAP. SAND TRAP,
CHEMICAL HOLDING TANK
X
$8.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
58.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
=
21
PRIVATE SEWAGE DISPOSAL/SVS
X
320.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
Card# See Cover Sheet
0 VISA 0 MASTERCARD
EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
8.00
TOTAL PERMIT FEE DUE:
14.00
AUTHORIZED SIGNATURE:
i;
Received Time Oct. 2. 2012 10:27AM No. 0186
REVISED 9/26'05