2012, 05-31 Permit App: BLD-2012-0783 Gas PipingSOokane
.Malley
Community Development
Plumbing Permit Application Fl Commercial
Pcrmit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
n AVIV. spokanevallev.ore.com
Mal or Fax To:
Norrn's Excavating, Inc.
P0Box 574
Veradale, WA 99037
Fax: 892-0432
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NAP -Zorz- 0783
PERMIT NUMBER:
PERMIT FEE: tit fq-
Residential
SITE ADDRESS: _1021 S Calvin
Building owner
DESCRIPTION OF WORK
Name: Fuller
Phone: 922-1531
..
Fax:
Address: SAME
City: State:
Zip:
Contractor
WATER CLOSET, BIDETS
1
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:
X
Con tact
-
Name: Sheila Gibbons
Phone: 928-0580
AUTHORIZED SIGNATURE:
REVISED 8./26/05
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DESCRIPTION OF WORK
0 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
56,00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$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
$6.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
56.00
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
-
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
1
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
58.00
-
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
56.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
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 0 See Cover Sheet
N VISA 0 MASTERCARD
_
SUBTOTAL
12.00
PROCESSING FEE
37.00
EXPIRES:
TOTAL PERMIT FEE DUE:
49.00
AUTHORIZED SIGNATURE:
REVISED 8./26/05
2P4prIPPRRIIQ 2utzenexq SWJOM epT:nT 21 Tr Rew