2012, 09-18 Permit App: BLD-2012-1612 Plumbing FixturesSPOlilIey
ane
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
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Plumbing Permit Application
Mail or Fax To:
Norm's Excavating, Inc. 1766.°N
PO Box 574
Veradale, WA 99037
Fax: 892-0432
11
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PERMIT NUMBER: gId - 12
PERMIT FEE: 6 /
Commercial [E] Residential
SITE ADDRESS: _4520 N Calvin
Building owner
DESCRIPTION OF WORK
# OF UNITS
Name: Lamb Phone: 953-3820
Fax:
TOTAL AMOUNT
Address: SAME
City:
State:
Zip:
Contractor
5600
=
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
56.00
Name: Sheila Gibbons
Phone: 928-0580
SHOWERS (PER TRAP)
BATH STALL, ON-SITE BUILT
AUTHORIZED SIGNATURE:
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REVISED Si26/06
1060 2i 81 daS
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
5600
=
6.00
2
URINALS
X
$6.00
3
TUBS
X
56.00
4
SHOWERS (PER TRAP)
BATH STALL, ON-SITE BUILT
1
X
56.00
8.00
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
56.00
-
7
CLOTHES WASHER
X
56.00
8
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
16
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
X
56.00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
.
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
Card# See Cover Sheet
El VISA 0 MASTERCARD
SUBTOTAL
24.00
PROCESSING FEE
37.00
EXPIRES:
TOTAL PERMIT FEE DUE:
61.00
AUTHORIZED SIGNATURE:
a • el 7r4,n7papnQ
2utl.eneoxR
REVISED Si26/06
1060 2i 81 daS