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2012, 07-10 Permit App: BLD-2012-1062 Plumbing FixturesStiolcane ....00.1F Val ley Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development 11112: ora com Plumbing Permit Application Mail or Fax To: Norm's Excavating, Inc. 6S9 '0 NI " PO Box 574 Veradale, WA 99037 Fax: 892-0432 Commercial WVOY6 'Ol aui!1 PA! p, AO 10\7- 10(01 PERMIT NUMBER: PERMIT FEE: Residential SITE ADDRESS: I 8512 E Bow Building owner DESCRIPTION OF WORK # OF UNITS Name: Ulrich Phone: 926-4322 Fax: TOTAL AMOUNT Address: SAME City: State: Zip: Contractor $6.00 - 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: NORMSEI972BM City Business License No: Contact X 55.00 Name: Sheila Gibbons Phone: 928-0580 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT AUTHORIZED SIGNATURE: - REVISED V26/05 911-rni;pAorlItn .=MACILA c.•c:an 2T nT Tnr DESCRIPTION OF WORK # OF UNITS X COST TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X $6.00 - 6.00 2 URINALS X 86.00 = 3 TUBS X 55.00 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 1 X 86.00 = 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 GARBAGE DISPOSAL X 86.00 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 86.00 ., 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 86,00 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER VACUUM BREAKER, CHECK VALVE, AND FLP.B.P.D. FOR VATS, TANKS, BOILERS X X 86.00 86.00 , = 17 CROSS CONNECTION DEVICE 10 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 86.00 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 21 PRNATE SEWAGE DISPOSAL/SYS X $20.00 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 METHOD OF PAYMENT: 0 CASH 0 CHECK Card# See Cover Sheet SUBTOTAL 24.00 CA VISA 0 MASTERCARD PROCESSING FEE 37.00 EXPIRES: TOTAL PERMIT FEE DUE: 61.00 AUTHORIZED SIGNATURE: - REVISED V26/05 911-rni;pAorlItn .=MACILA c.•c:an 2T nT Tnr