2012, 08-21 Permit App: BLD-2012-1366 Plumbing Fixtures2�gE�
Community Development
Plumbine Permit
srrE ADDRESS: _11415 E Empi
T
avating, Inc.
Nt6 'ON AV[ 0:0 Zl06 [6 '2ny awil paA1 3
I
JA 99037 /
132 PERMIT NUMBER: 36
PERMIT FEE: Y
ercial ® Residential
Building owner
DESCRIPTION OF WORK
Mail or 1
Name: Matthews
Phone: W8-5685 Fax:
Norm's I
Address: SAME
City: State:
PO Box
Permit Center
WATER CLOSET, BIDES
Veradal
11707 E Sprague Ave, Suite 106
Plione: 509/928-0580
Fax: 89:
Spokane Valley, WA 99206
City: Veradale State: WA
Zip. 99037
(509)688-0036 FAX: (509)688-0037
106- tioln
❑ Com
srrE ADDRESS: _11415 E Empi
T
avating, Inc.
Nt6 'ON AV[ 0:0 Zl06 [6 '2ny awil paA1 3
I
JA 99037 /
132 PERMIT NUMBER: 36
PERMIT FEE: Y
ercial ® Residential
Building owner
DESCRIPTION OF WORK
I
Name: Matthews
Phone: W8-5685 Fax:
COST
Address: SAME
City: State:
Zip:
Contractor
WATER CLOSET, BIDES
Name: Norm's Excavating,Inc
Plione: 509/928-0580
Fax: 509/892-0432
Address: PO Box 574
City: Veradale State: WA
Zip. 99037
License No: NORMSE]972BM
City Business License No:
X
Contact
-
Name: Sheila Gibbons
Ph4e: 928-0580
AUTHORIZED SIGNATURE:
s•d
zs�ozsesos
21-114eneOx3 SWOON
RE\RSED 826/05
e9t,=6o zi iz 2nd
DESCRIPTION OF WORK
I
# OF UNITS
X
COST
-
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDES
X
$6.00
—
2
URINALS
X
$6.00
-
3
TUBS
X
$6.00
=
4
SHOWERS PER TRAP
BATH, STALL, ON-SITE BUILT
X
$6.00
-
5
SINKS
LAVS/BASINS, BAR, FLOOR,ITCHEN,
LAUNDRY, UTILITY, JANITORIPHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER.
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
-
8
GARBAGE DISPOSAL
X
$6.00
-
9
WATER SOFTENER
X
$6.00
-
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, C NDENSATE
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
f
GRINDER SUMP PUMP
X
$6.00
-
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, qOSE BIB,
STEAMERX
PROOFER, CARBONATOR, SW P COOLER
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TAN S. BOILERS
I
X
$6.00
=
16
INTERCEPTORS
GREASE TRAP, SAND T�AAP,
CHEMICAL HOLDING TANK
X
$6.00
-
19
MEDICAL GAS r outlet
NITROUS, OXYGEN
X
$6.00
-
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
-
21
PRIVATE SEWAGE DISPOSAL/SYS
X
$20.00
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ® VISA ❑ MASTER ARD
Card# See Cover Sheet EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
8.00
TOTAL PERMIT FEE DUE:
14.00
AUTHORIZED SIGNATURE:
s•d
zs�ozsesos
21-114eneOx3 SWOON
RE\RSED 826/05
e9t,=6o zi iz 2nd