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2012, 09-05 Permit App: BLD-2012-1491 Water PipingPermit Center Spokane 11707E Spree Ave, Suite 106 s Spokane Valley, WA 99206 ®��� (509)688-0036 FAX: (509)688-0037 Community Development--•!;a��..l br: :+re,vun: Plumbing Permit Application Mall or Fax To:0 Norm's Excavating, Inc s z L6 N PO Box 574 Veradale, WA 99037 Fax: 892-0432 n Commercial WVbb 6 ZIOb 'y 'dag awll p9Al3D9 PERMIT NUMBER: I3 1Gl —12 PERMIT FEE: 7 Y O.a<7, Residential SITE ADDRESS: 14315 E Cataldo Building owner DESCRIPTION OF WORK # OF UNITS Name: Hughes Phone: 981-3364 Fax: TOTAL AMOUNT Address: SAME City: State: Zip: Contractor 16.00 = 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 16.00 = Name: Sheila Gibbons Phone: 928-0580 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT AUTHORIZED SIGNATURE: S • d 2E1028B60S 2 Ut28ABOX3 Sw.JON REVISED 8/2105 860:60 ZT SO daS DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X 16.00 = 2 URINALS X 16.00 = 3 TUBS X 16.00 = 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. F000, PREP/CULINARY MEAT X 16.00 = 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X 16.00 = 9 WATER SOFTENER X $8.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X 16.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 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 $8.00 = 18 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB. STEAMER PROOFER, CARBONATOR, SWAMP COOLER X $6.00 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X $6.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS. OXYGEN X 16.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAL/SYS X 520.00 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK IE VISA 0 MASTERCARD Card# See Cover Sheet EXPIRES: SUBTOTAL 6.00 PROCESSING FEE 8.00 TOTAL PERMIT FEE DUE: 14.00 AUTHORIZED SIGNATURE: S • d 2E1028B60S 2 Ut28ABOX3 Sw.JON REVISED 8/2105 860:60 ZT SO daS