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