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2012, 09-18 Permit App: BLD-2012-1602 Plumbing Fixturesii kanr e Valley Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development wm w_spol:aneval lev.nre.com Plumbing Permit Application Mall or Fax To: Norm's Excavating. Inc. 8[ 6 6 p N PO Box 574 Veradale, WA 99037 Fax: 892-0432 El Wv 8 6[06 .8l."S 13 1\! 34 PERMIT NUMBER: /3 (c("12 PERMIT FEE: 6 I C2-c25c)( Commercial ® Residential ((02 SITE ADDRESS: 1415 N Girard Ct Building owner DESCRIPTION OF WORK *OF UNITS Name: Holman Phone: 928.1745 Fax: TOTAL AMOUNT Address: SAME TOILETS City: State: Zip: Contractor 56.00 = 6.00 Name: Norm's Excavating, Inc URINALS Phone: 509/928-0580 Fax: 509/892-0432 Address: PO Box 574 $6.00 City : Veradale State: WA Zip: 99037 License No: NORMSEI972BM TUBS City Business License No: Contact $6.00 = Name: Sheila Gibbons SHOWERS (PER TRAP) Phone: 928-0580 1 AUTHORIZED SIGNATURE: 2-d 2E17026860S ur4ene3x3 SWJON REVISED 8/26/05 e60:80 21 81 daS DESCRIPTION OF WORK *OF UNITS X COST TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X 56.00 = 6.00 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 1 X 56.00 = 6.00 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 1 X $6.00 = 6.00 6 DISHWASHER X 56.00 = 7 CLOTHES WASHER X 56.00 = 8 GARBAGE DISPOSAL X 56.00 = 9 WATER SOFTENER X 56.00 = 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 $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALIATION, ALTERATION, REPAIR, REVERSALS 1 X 56.00 = 6.00 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 = 20 MISCELLANEOUS PLUMBING FIXTURE X 56.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X_ $15.00 = METHOD OF PAYMENT: ❑ CASH 0 CHECK ® VISA D MASTERCARD Card# See Cover Sheet EXPIRES: SUBTOTAL 24.00 PROCESSING FEE 37.00 TOTAL PERMIT FEE DUE: 61.00 AUTHORIZED SIGNATURE: 2-d 2E17026860S ur4ene3x3 SWJON REVISED 8/26/05 e60:80 21 81 daS