2012, 02-07 Permit App: 12000273 ROW, Sewer, Plumbing FixtureFeb 07 12 11:47a
Spokane
��alley
Community Development
Plumbing Permit
Norms Excavating
Pcrmit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
WWW.SpOknnevalleyont.conl
Application ❑
5098920432
Mail or Fax To:
Norm's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892-0432
p.2
PERMIT NUMBER:
PERMIT FEE:
Commercial ® Residential
SITE ADDRESS:
13921 E Boone
Building owner
DESCRIPTION OF WORK
Name: Freelender
Phone: 216-5778
Fax:
Address: SAME
City: State:
Zip:
Contractor
WATER CLOSET, BIDETS
1
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:
X
Contact
=
Name: Sheila Gibbons
Phone: 928-0580
AUTHORIZED SIGNATURE: • .
Received Time Feb. 7. 2012 11:14AM No.6333
REVISED B/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
56.00
=
6.00
2
URINALS
X
36.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
1
X
$6.00
=
6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
$6.00
=
6.00
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$8.00
=
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
36.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, 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
$6.00
=
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
$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
320.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
315.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK El VISA Q MASTERCARD
Card See Cover Sheet EXPIRES:
SUBTOTAL
24.00
PROCESSING FEE
TOTAL PERMIT FEE DUE:
24.00
AUTHORIZED SIGNATURE: • .
Received Time Feb. 7. 2012 11:14AM No.6333
REVISED B/26/05