2011, 08-09 Permit App: 11002380 Plumbing Fixtures` Permit Center
Spokane 11707 E Sprague Ave, Suite 106
Salle Spokarie Valley, WA 99206
Valley (509)688-0036 FAX: (509)688-0037
Community Development }Iwwspokunevallev.ore.cont
Plumbing Permit Application ❑ Commercial ® Residential
MNorm'all osr FaxExcavaTO:ting, Inc 8188'°N WVZS:OI IIOZ '6 'end "ni P9Al9J9N
PO Box 574
Veradale, WA 99037
Fax: 892-0432
PERMIT NUMBER:
PERMIT FEE:
SITE ADDRESS:
14117 E Boone
Building owner
DESCRIPTION OF WORK
# OF UNITS
Name: Dietzel
Phone: 995-0387
=
Fax:
Address: SAME
City:
State:
Zip:
Contractor
36.00
=
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
36.00
=
Name: Sheila Gibbons
Phone: 928-0580
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
AUTHORIZED SIGNATURE:
E - d ZEb06860S
2utq.eneox3 sw.J04
REVISED 826/05
eST:OT TI 60 2fb
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET BIDETS
1
X
36.00
=
6.00
2
URINALS
X
$6.00
=
3
TUBS
X
36.00
=
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
36.00
=
8
GARBAGE DISPOSAL
X
36.00
=
9
WATER SOFTENER
X
$8.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
36.00
=
11
FLOOR DRAINS
AREA CASE, COIL. TRENCH. CONDENSATE
X
36.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
36.00
=
13
FOUNTAINS, DRINKING
X
36.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
1
X
36.00
=
6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
36.00
=
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
=
16
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL MOLDING TANK
X
36.00
=
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:
0 CASH 0 CHECK la VISA 0 MASTERCARD
Card# see cover sheet EXPIRES:
SUBTOTAL
2440
PROCESSING FEE
TOTAL PERMIT FEE DUE:
2440
AUTHORIZED SIGNATURE:
E - d ZEb06860S
2utq.eneox3 sw.J04
REVISED 826/05
eST:OT TI 60 2fb