2012, 04-26 Permit App: BLD-2012-0495 Plumbing FixturesjMalley
Community Development
Plumbing Permit
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
'pnn;lnacali.; ore cnm 111Application
Mail or Fax To.
Norm's Excavating, Inc. 9 L C L N
PC) Box 574
veradale, WA 99037
Fax: 692-0432
Commercial
Resi
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PERMIT NUMBER:
PERMIT FEE:
ential
sITE ADDRESS: 11923 E Frederick
Building owner
Name: Noack
Phone: 922-1331
Fax:
Address: SAME
- City:
ctatc:
Zip:
Contractor
Name: Norm's Excavating, Inc
Phone: 509/928-0580
Fax: 509/892-0432
Address: PC) Box574
City - Veradale State:
WA
Zip: 99037
License No. NORMSE1972BM
City Business License No
Contact
Name: Sheila Gibbons
Phone: 928-0580
DESCRIPTION OF WORK
M OF UN
rrs
x
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET. BIDETS
1
X
$6.00
6.00
2
URINALS
x
56 00
3
TUBS
x
56 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 -RAV, FOOD. PREP/CULINARY MEAT
X
$6.00
6.00
0
DISHWASHER
X
56 00
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
$6 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
Vo
14
WATER PIPING/DRAIN-IN WASTE.
VENT, PLUMBING, REVERSAL
NSTALLAT1ON, 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
16
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
$6.00
21
PRIVATE SEWAGE DISPOSAIJSYS
x
520.00
22
INDUSTRIAL WASTE
INTERCEPTOR
x
515.00
METHOD OF PAYMENT:
0 CASH 0 CHECK
Card See Cover Sheet
AUTHORIZED SIGNATURE:
El VISA 0 MASTERCARD
EXPIRES:
/. • .'
SUBTOTAL
24.00
PROCESSING FEE
37.00
TOTAL
PERMIT FEE DUE:
61.00
9'd 2E17026960S 2uneneox3 suiJoN
REVISED 8,26/05
eLS:60 ZT 92 .Jdd