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2012, 10-02 Permit App: BLD-2012-1713 Plumbing Fixtures
Mail or Fax To: Norm's Excavating, Inc PO Box 574 Permit Center Veradale, WA 99037 SOokane 11707E Sprague Ave, Suite 106 Fax. 892-0432 Spokane Valley, WA 99206 v -A (509)688-0036 FAX: (509)688-0037 Community Development %\ sm. souk anc' alley nr-COM Plumbing Permit Application n Commercial SITE ADDRESS: _105 N Harmony b10-1012,- j7?3 88L0'°N 08E:01 ZIOZ 'Z 'P0 ;Lull p9AiDaa PERMIT NUMBER: PERMIT FEE: Residential AUTHORIZED SIGNATURE: - ci •i""" ` E'd 2E17026860S 2ui3eneOx3 SWJON REVISED Rr1N05 eS2:0T 21 20 330 DESCRIPTION OF WORK Building owner X COST Name: Mcdchill Phone: 922-9029 Fax: Address: SAME City: State: Zip: Contractor 56'00 = 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: NORMSE1972BM City Business License No' Contact TUBS Name: Sheila Gibbons Phone: 928-0580 $6 W 3 4 AUTHORIZED SIGNATURE: - ci •i""" ` E'd 2E17026860S 2ui3eneOx3 SWJON REVISED Rr1N05 eS2:0T 21 20 330 DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT TOILETS WATER CLOSET, BIDETS 1 X 56'00 = 600 1 URINALS X $6.00 = 2 TUBS X $6 W 3 4 SHOWERS (PER TRAP) BATH. STALL ON-SITE BUILT 1 X $6.00 = 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 $6.00 = 7 CLOTHES WASHER X $6.00 = 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 = FLOOR DRAINS AREA, CASE COIL TRENCH, CONDENSATE X $6.00 = 11 12 ROOF DRAINS/OVERFLOW DRAINS X $600 = 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 GRINDER, SUMP PUMP X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER. HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER X $8.00 = CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS. BOILERS X $6.00 = 17 18 INTERCEPTORS GREASE TRAP, SAND TRAP. CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS. OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X $20 00 = INDUSTRIAL WASTE INTERCEPTOR X $15.00 = 22 METHOD OF PAYMENT: 0 CASH ❑ CHECK ® VISA ❑ MASTERCARD FxPIRFs: SUBTOTAL 24.00 PROCESSING FEE 37.00 TOTAL PERMIT FEE DUE: 61.00 AUTHORIZED SIGNATURE: - ci •i""" ` E'd 2E17026860S 2ui3eneOx3 SWJON REVISED Rr1N05 eS2:0T 21 20 330