2012, 03-05 Permit App: BLD-2012-0094 Plumbing FixturesMar 05 12 08:54a Norms Excavating
snioka e
Malley
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokancvallcy ore.com
Plumbing Permit Application
5098920432
Mail or Fax To:
Norrn's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892-0432
P- 3
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PERMIT NUMB
ER:
PERMIT FEE
❑ Commercial ® Residential
SITE ADDRESS:
2121 N. Bradley
Building owner
Name: Cook
Phone:
Fax:
Address: SAME
City:
State:
Zip:
Contractor
,
Name: Norrn'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
Name: Sheila Gibbons
Phone: 928-0580
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
x
86.00
6.00
2
URINALS
X
$6.00
3
TUBS
X
$6.00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
86.00
6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
86.00
6.00
6
DISHWASHER
X
86.00
7
CLOTHES WASHER
X
$6.00
8
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
86.00
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
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 OISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE
INTERCEPTOR
X
815.00
METHOD OF PAYMENT:
0 CASH 0 CHECK
Cards See Cover Sheet
® VISA 0 MASTERCARD
EXPIRES:
AUTHORIZED SIGNATURE: r • . 7e? `� „
Received Time Mar. 5. 2012 8:19AM No.6644
SUBTOTAL
24.00
PROCESSING FEE
6.00
TOTAL PERMIT FEE DUE:
32.00
REVISED t26/05