2011, 10-11 Permit App: 11003216 Plumbing FixturesPermit Center
S 'jk�ne 11707 E Sprague Ave, Suite 106
-'"`''""�t L,17ey Spokane Valley, WA 99206
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V4liG (509)688-0036 FAX: (509)688-0037
Community Development www_spokancvalley. org.coin
Plumbing Permit Application
SITE ADDRESS: 7920 E Grace
Mail or Fax To:
Norm's Excavating, Inc. 17L 8 N
PO Box 574
Veradale, WA 99037
Fax: 892-0432
WV66:6 ll06 p1AI131
PERMIT NUMBER: / 1 - 3 z._11.,
PERMIT FEE: 3
❑ Commercial ® Residential
L so%Z. iloo7
Building owner
DESCRIPTION OF WORK
Name: Lodico
Phone: 921-5837
Fax:
Address: SAME
City: State;
Zip:
Contractor
WATER CLOSET, BIDETS
Name: Norm's Excavating, Inc
Phone: 509/928-0580
Fax: 509/892-0432
Address: PO Box 574
City : Veradale Stale: WA
Zip: 99037
License No: NORMSEI972BM
City Business License No:
X
Contact
=
Name: Sheila Gibbons
Phone: 928-0580
AUTHORIZED SIGNATURE:
• 7
a • d 2E1'026860S
2ui1eneox3 swuow
REVISED 8/26/05
eSS=BO TT Ti 400
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
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, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
86.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
86.00
=
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, 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
86.00
=
6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
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.PD. FOR: VATS. TANKS, BOILERS
X
86.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
'NITROUS. OXYGEN
X
86.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAIJSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
!
0 CASH 0 CHECK ® VISA ❑ MASTERCARD
Card# See Cover Sheet EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
37.00
TOTAL PERMIT FEE DUE:
43.00
AUTHORIZED SIGNATURE:
• 7
a • d 2E1'026860S
2ui1eneox3 swuow
REVISED 8/26/05
eSS=BO TT Ti 400