2012, 03-19 Permit App: BLD-2012-0179 Plumbing FixturesMar 19 12 10:22a Norms Excavating
t
eogON\. Permit Center
Spokane 11707 E Sprague Ave, Suite 106
s Valley Spokane Valley, WA 99206
® (509)688-0036 FAX: (509)688-0037
Community Development www.spokancval a.ore col
Plumbing Permit Application n Commercial ® Residential
5098920432
Mail or Fax To:
Nom's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892-0432
AALv—a0/2 —0/
p-2
79
PERMIT NUMBER:
PERMIT FEE: .6r j7 00
SITE ADDRESS:
13725 E Hcroy
Building owner
DESCRIPTION OF WORK
# OF UNITS
Name: Lawson
Phone: 868-3558
Fax:
TOTAL AMOUNT
Address: SAME
City: State.
WATER CLOSET, BIDETS
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• NORMSEI972BM
City Business License No:
Contact
$6.00
=
Name: Sheila Gibbons
Phone: 928-0580
BATH, STALL, ON-SITE BUILT
AUTHORIZED SIGNATURE:
Received Time Mar. 19. 2012 10:47AM No.6794
REVISED S/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
X
56.00
=
3
TUBS
X
$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
X
56.00
8
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 DRAJNS/OVERFLOW
DRAINS
X
56.00
=
13
FOUNTAINS. DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR.
REVERSALS
1
X
56.00
=
6.00
11S
I SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
moo
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56.00
=
117
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALvE,
AND R P B P D. FOR: VATS TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
ie
MEDI•CAt GA5 (per outlet/ 1
NITROUS, OXYGEN
X _ 5600_.__
_
_J
20
_.__
MISCELLANEOUS PLUMBING
FIXTURE
___._ _ .
—1
X 56 OD
=
21
PRIVATE SEWAGE DISPOSAL/SYS
X 529 00
=
"
22
INDUSTRIAL WASTE
INTERCEPTOR
X 515.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
Card# See Cover Sheet EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
�y G
6- 0
TOTAL PERMIT FEE DUE:
(y 0 e
AUTHORIZED SIGNATURE:
Received Time Mar. 19. 2012 10:47AM No.6794
REVISED S/26/05