2012, 03-01 Permit App: BLD-2012-0082 Plumbing Fixtures��lley
ne
Community Development
Plumbing Permit
Permit Center
11707 E Sprague Ave, Suite 106
Spokanc Valley, WA 99206
(509)688-0036 FAX (509)688-0037
n3« ..5pD anevaiIcr-acorn
pplication
Mail or Fax To:
Norm's Excavating, Inc. E Q 9 9 '0N
PO Box 574
Veradale, WA 99037
Fax: 892-0432
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61-64— 20/Z - 0092
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial ® Residential
SITE ADDRESS: 7102 E Bridgeport
Building owner
Name: Davis
Phone: 638-3261 Fax:
Address: SAME
City: State:
Zip:
Contractor
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: NORMSE1972B1V
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
56.00
6.00
2
URINALS
X
$6.00
3
TUBS
x
$6.00
4
SHOWERS (PER TRAP'
BATH, STALL, ON-SITE BUILT
1
X
56.00
6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
56.00
6.00
6
DISHWASHER
X
$6.00
7
CLOTHES WASHER
X
56.00
B
GARBAGE DISPOSAL
X
56.00
9
WATER SOFTENER
X
56.00
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
58.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
56.00
12
ROOF DRAINS/OVERFI OW
DRAINS
X
56.00
13
FOUNTAINS, DRINKINC
X
56.00
14
WATER PIPING/DRAIN- N WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
1
X
56.00
6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$6.00
17
CROSS CONNECTION •)EVICE
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
56.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
21
PRIVATE SEWAGE D1S )OSAL/SYS
X
520.00
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
METHOD OF PAYMENT:
❑ CASH 0 CHECK
Card# See Fax cover
AUTHORIZED SIGNATURE:
G•d
E VISA 0 MASTERCARD
EXPIRES: 03/2012
2F17112RRRfG
SUBTOTAL
24.00
PROCESSING FEE
TOTAL PERMIT FEE DUE:
24.00
REVISED 8/26'05
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