2006, 02-22 Permit App: 06000512 PipingFeb 20 06 02'07p
Sheila Gibbons
Permit Center
StOkane 11707 E Sprague Are, Suite 106
`''3lley Spokane Valley, INA 99200
(529168K-0036 FAX: U091638-0037
G:nt:awun- Dcvelopmrlt w w SpuA aneva1e'i,Ire Can:
Plumbing Permit Application
,Mail a Fa. To.
Norm's Excaea3nc, Inc.
PO Bos 574
VeradeIe, WA 93037
Fax: 302-0432
509-892-0432
P.5
PERMIT NGb1[3ER: C5 (a—
PERMIT EEE: 00
Commercial [ Residential
SITE ADDRESS: 5!3 S Home Rd
5 331. 11 ID
BuiWlnu owner
DESCRIPTION OF WORK
MOF UNITS
X
Nsve_ A iCClw:nev
Phone' 533-1 130
TOTAL AMOUNT
Fa\'
TOILETS
Address: SAME
City State
X
5:.03
Zln
Contractor
2
URINALS
Name Bulk -nap Plumbing
Phone: 503/921-5913
=
Fax:
Address: 3414 S Adams Rd.
City: Vetadate Suit 4
SVA
X
Sia' 99037
License No: BELICNP'071136
City Business Livens: No
4
SHOWERS (PER TRAP)
SIHKS
SATE STALL, ON-SITE GUILT
LAYS/BASINS, BAF, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY FOOD. PREP/CULINARY MEAT
Contsct
X
X
S5 00
59.00
=
=
Name: She On Gtbbmis
Phone' 92S-0580
DISHWASHER
4ITHOR1"/.IF' ,:GNATIJICE.
FEB 20 2006 1tit18 ,
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.
509 892 0452
P0GE.C5
DESCRIPTION OF WORK
MOF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
5:.03
=
2
URINALS
X
S-5 C'3
=
TUBS
X
5-300
=
4
SHOWERS (PER TRAP)
SIHKS
SATE STALL, ON-SITE GUILT
LAYS/BASINS, BAF, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY FOOD. PREP/CULINARY MEAT
X
X
S5 00
59.00
=
=
5
-
DISHWASHER
X
85 CJ
=
CLOTHES WASHER
X
Se 00
=
2
GAREAGE DISPOSAL
X
Se.00
=
5
:LATER SCETENER
X
06.00
=
10
ELECTRIC PDT WATER TANK
NOTE. IF GAS. SEE MECHANICAL
X
Se.00
--
FLOOR DRAINS
FLOOR
AREA. CASE. COIL TRENCH CONDENSATE
X
53.00
=
,.
ROOF ORAINS'OVERFLOV
DRAINS
X
55-00
I =
13
FOUNTAINS DRINKING
X
Si 00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING. REVERSAL
NSTALLATION, ALTERATION, REPAIR.
REVERSALS
X
56.00
=
600
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
15
WATER USING DEVICE
ICEAWOR COFFEE MAKER, HOSE BIB,
STEAMER
PROOF -ER. CARBONATOR, SWAMP COOLER
VACUUM BREAKER, CHECK VALVE,
AND R P_B RD FOR VATS. TANKS BOILERS
X
X
54.00
5E00
1.
CROSS CONNECTION CEVICE
15
INTERCEP TORS
GREASE TP AP, SAND TRAP,
CHEMICAL HOLOING TANK
X
5600
=
15
MEDICAL OAS (pot cc0e:1
NITROUS, ORIGEN
X
50.00
--
20
MISCELL NEOUS PLUMBING
MISCELLANEOUS
FCCT'JRE
X
56 00
21
PRIVATE SEWAGE DISPOSAL/SYS
X
520 C3
=
22
INDUSTRIAL. WASTE
INTERCEPTOR
X
515 CO
=
METHOD CF PAYMENT.
0 CA r., - — ----_ C_tnc:, 0 MASTERCARD
/.HS_ __ .. _ _ _ _ ., _. _
5011 TOTAL
600
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE
41 00
4ITHOR1"/.IF' ,:GNATIJICE.
FEB 20 2006 1tit18 ,
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.
509 892 0452
P0GE.C5
City of Spokane Valley
Building Dept
Receipt
Receipt Number: 4398 Customer Number
Projects
Miscellaneous Items
Tender
Full
Project Nbr Inv Nbr i Fee Ami . Inv Amt Ory n[ PAID Pint
06000508 1 ' $70.00 _$70.00 _$70.001 $70.00 ❑�
06000509 1 [ $59.00. - _...-__$59.00 . _ $59.001$59.00 El
06000511 1 _ $70.00 $70.00, _ -_$70.00.j $70.00
06000512 1 _ $41.00 _$4,1.00 =$41.00 ] _ - _$41.00.; $41.00 0
06000513 1 I $70.00 _ $70.00 __$70.0Q, .; $70.00 0
06000529 1 _ __$41.00 _$41.00 __$41.00) $41.00 ❑�
06000531 1 `___$70.00_ [_____$70 00_1 [v$70.00_1 $70.00 ❑�
06000532 1 ___ $41.0 _$41.00_1 __$41.00) $41.00 ❑�
06000533 1 [ _$70.001 E_$70.00i (__$70.00_1 $70.00 0
Total: ! $532.0.0 $532.00) [ $532.00,1 $532.00
Total PAID: $532.00
IType Check Acct Balance CC Nbr Exp Date TENDERED
VISA 1
1 f —txxxxxxxxxxxx0895 09/2009f 532.00
Payer:
Total TENDERED: 532.00
Over /(Short) $0.00
Change $0.00
Notes:
Tran Date/Time: 02/22/2006 12:05:36 PM
By: A_Blake
Logon User: bldgdesk
Station: CX_SV00015
Override By:
Printed: 02/22/2006 12:05:40 PM Page 1 of 1