2011, 09-20 Permit App: 11002969 ROW, Sewer, Plumbing Fixtures/r •
Permit Ccntcr
SpOkanCelse 11707 E Sprague Ave, Suite 106
jValley
Community Development
Plumbing Permit
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
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Application ❑ Commercial ® Residential
Mail or Fax To
Norm's Excavating, Inc. 6 Zrr 7 0 N
PO Box 574
Veradale, WA 99037
Fax' 892-0432
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PERMIT NUMBER:' / t ' ib 1
PERMIT FEE:
SITE ADDRESS:
12024 E Fairview
Building owner
DESCRIPTION OF WORK
# OF UNITS
Namc: Janke
Phone. 924-1153
=
Fax:
Address: SAME
City-
State:
Zip:
Contractor
56.00
=
6.00
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
56.00
=
Name: Sheila Gibbons
Phone: 928-0580
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
AUTHORIZED SIGNATURE:
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REVISED 826/05
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DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
56.00
=
6.00
2
URINALS
X
56,00
=
3
TUBS
1
X
56.00
=
6 00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
56,00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR. KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
56.00
=
600
8
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
56.00
=
8
GARBAGE DISPOSAL
X
58.00
=
9
WATER SOFTENER
X
58.00
=
10
ELECTRIC HOT WATER TANK
NOTE. IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
46.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
=
13
FOUNTAINS, DRINKING
X
58.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
1
X
56.00
=
800
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
18
WATER USING DEVICE
ICE AN/OR COFFEE MAKER. HOSE BIB,
STEAMER
PROOFER. CARBONATOR, SWAMP COOLER
X
58.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR. VATS TANKS BOILERS
X
58.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
58.00
=
19
MEDICAL GAS (per outlet)
NITROUS. OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
O CASH 0 CHECK ® VISA 0 MASTERCARD
Card# see cover sheet EXPIRES:
SUBTOTAL
24.00
PROCESSING FEE
TOTAL PERMIT FEE DUE:
24.00
AUTHORIZED SIGNATURE:
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REVISED 826/05
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