HomeMy WebLinkAbout2011, 10-25 Permit App: 11003400 Sewer, Plumbing Fixtures, ROW100
Sikikane
.0000Milley
Community Development
Plumbing Permit
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www..s_pok arieval v.org.corn
Application
Mail or Fax To:
Norm's Excavating, Inc_
PO Box 574
Veradale, WA 99037
Fax: 892-0432
V :6 'DO "ILL PA!"
PERMIT NUMBER:
PERMIT FEE:
ri Commercial LE Residential
SITE ADDRESS:
3004 N Dick
Building owner
DESCRIPTION OF WORK
# OF UNITS
Name: Read
Phone:
Fax:
TOTAL AMOUNT
Address: SAME
City:
State:
Zip:
Contractor
56.00
=
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
Cy Business License No:
Contact
X
56.00
Name: Sheila Gibbons
Phone: 928-0580
4
SHOWERS (PER TRAP)
AUTHORIZED SIGNATURE:
c • el
_
7c-4,n7Qapnc
2utaeneoxa stuJow
REVISED x/26/o5
eS2:60 II S2 400
DESCRIPTION OF WORK
# OF UNITS
X
COST
-
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
56.00
=
6.00
2
URINALS
X
56.00
=
3
TUBS
1
X
56.00
=
6.00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
56.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
56.00
6.00
8
DISHWASHER
X
56.00
-
7
CLOTHES WASHER
X
56.00
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
56.00
-
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
56.00
-
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
-
13
FOUNTAINS, DRINKING
X
56.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
1
X
56.00
6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
18
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
X
56.00
56.00
=
18
INTERCEPTORS
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
METHOD OF PAYMENT:
0 CASH 0 CHECK to VISA 0 MASTERCARD
Card# see cover sheet EXPIRES:
SUBTOTAL
24.00
PROCESSING FEE
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
c • el
_
7c-4,n7Qapnc
2utaeneoxa stuJow
REVISED x/26/o5
eS2:60 II S2 400