2012, 04-04 Permit App: BLD-2012-0297 Plumbing FixturesApr 04 12 11:24a
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Norms Excavating
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokancval lev.ore com
Plumbing Permit Application
a ADDRESS: 13814 E Herov
5098920432
Mail or Fax To:
Norm's Excavating, Inc.
PO Box 574
Veradalo, WA 99037
Fax: 892-0432
9 Commercial
(t1 —20/2 —0
P.
247
PERMIT NUMBER:
PERMITthb: 43 6(, 00
Residential
Banding owner
DESCRIPTION OF WORK
Name: Huseby Phone: 922-1172 Fax:
X
COST
Address: SAME
City: State:
Zip:
Contractor
WATER CLOSET, BIDETS
1
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:
X
Contact
Name: Sheila Gibbons
Phone: 928-0580
AUTHORIZED SIGNATURE:
(71,44 1 ,6('R /C /
Received Time Apr. 4. 2012 11.46AM No, 7035
REVISED 8/26/05
DESCRIPTION OF WORK
*1 OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
56.00
=
6.00
2
URINALS
X
$6.00
3
TUBS
X
36.00
=
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-RAY, FOOD, PREP/CULINARY MEAT
1
X
16.00
=
6.00
6
DISITYVASHER
X
56.00
7
CLOTHES WASHER
X
$6.00
8
GARBAGE DISPOSAL
X
$6.00
=
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
5680
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
13
FOUNTAINS, DRINKING
X
36.00
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
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
56.00
=
18
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
56.00
_
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
0 rein C..f ..er cr.em EXPIRES:
SUBTOTAL
24.00
PROCESSING FEE
37.00
TOTAL PERMIT FEE DUE:
61.00
AUTHORIZED SIGNATURE:
(71,44 1 ,6('R /C /
Received Time Apr. 4. 2012 11.46AM No, 7035
REVISED 8/26/05