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
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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