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2011, 09-07 Permit App: 11002762 Plumbing FixturesPermit Center Sook ne 11707 E Sprague Ave, Suite 106 es...0 Val ley Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development sysr w_spukanevnllcv.om&nm Plumbing Permit Application SITE ADDRESS: 8112 E Carlisle Mail or Fax To: Norm's Excavating, Inc. PO Box 574 Veradale, WA 99037 Fax: 892-0432 00Eb'°N WV91 01 HE '9 'dog Fl Commercial 2W11 p9A!1D PERMIT NUMBER: PERMIT FEE: S S Residential AUTHORIZED SIGNATURE: a'd 2Eb0268609 2uneneox3 sutuom REVISED N26/05 eI4:60 TI 90 daS DESCRIPTOR OF WORK Building X COST owner Name: Melaas Phone: 927-0857 Fax: Address: SAME City: State: Zip: Contractor 56.00 = 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 TUBS Name: Sheila Gibbons Phone: 928-0580 56.00 = AUTHORIZED SIGNATURE: a'd 2Eb0268609 2uneneox3 sutuom REVISED N26/05 eI4:60 TI 90 daS DESCRIPTOR OF WORK # OF UNITS X COST = TOTAL AMOUNT WATER CLOSET, BIDETS 1 X 56.00 = 600 1 TOILETS URINALS X 56.00 = 2 3 TUBS X 56.00 = SHOWERS (PER TRAP) BATH. STALL. ONSITE BUILT 1 X 56.00 = 6.00 4 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY. JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT X 56.00 = DISHWASHER X $6.00 6 7 CLOTHES WASHER X 56.00 = 8 GARBAGE DISPOSAL X 56.00 = 9 WATER SOFTENER X $6.00 = 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 = WATER PIPING/DRAIN-IN WASTE, VENT. PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR. REVERSALS 1 X 56.00 = 6.00 14 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 56.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X 56.00 = MISCELLANEOUS PLUMBING FIXTURE X 56.00 20 21 PRIVATE SEWAGE DISPOSAL/SYS X 520.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X 515.00 = METHOD OF PAYMENT: ❑ CASH 0 CHECK 0 VISA 0 MASTERCARD n__.,„ „a, an„„,, ehna+ FXPIRES: SUBTOTAL 55.00 PROCESSING FEE TOTAL PERMIT FEE DUE: 55.00 AUTHORIZED SIGNATURE: a'd 2Eb0268609 2uneneox3 sutuom REVISED N26/05 eI4:60 TI 90 daS