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2012, 03-05 Permit App: BLD-2012-0081 Plumbing Fixtures
a Permit Center Stamm 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development ww snokanevallev.o.^.coin Plumbing Permit Application ❑ Mail or Fax To: Norm's Excavating, Inc. PO Box 574 Veradale, WA 99037 Fax: 892-0432 E099'°N WVS17:6 6[06 'l ')PW anvil paAia3aa SCO - zofZ -008 PERMIT NUMBER: PERMIT FEE: 32 -Cp SITE ADDRESS: 13406 E Desmet f Commercial ® Residential Building owner DESCRIPTION OF WORK Name: Burke Phone: 701-9505 Fax: COST 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: Veradele State: WA Zip: 99037 License No: NORMSE1972BM City Business License No: X Contact = Name: Sheila Gibbons Phone: 928-0580 AUTHORIZED SIGNATURE: 2•d 2E17028860S 5ufeneox3 stuJoj.J t, "-- REVISED 1/26/05 861101 21 I0 -JEW 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 X 56.00 = 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 58.00 = 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 $6.00 = 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.O. 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 DISPOSAL/SYS X 520.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X 515.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK ® VISA 0 MASTERCARD Card# See fax cover EXPIRES: 03/2012 SUBTOTAL 24.00 PROCESSING FEE `' — V TOTAL PERMIT FEE DUE: 24.00 AUTHORIZED SIGNATURE: 2•d 2E17028860S 5ufeneox3 stuJoj.J t, "-- REVISED 1/26/05 861101 21 I0 -JEW