2013, 03-25 Permit App: BLD-2013-0491 Sewer ReversalPermit Center
Spokane401.1119\11707E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokrmecalley.c ,.com
Plumbing Permit Application
Mai or Fax To:
Norm's Excavating, Inc.
P.O. Box 30873
Spokane, WA 99223
Fax: 5091448-4906
Finail•Tinakifnnrmcanravatinn rnrn
n Commercial
X13 -d
9
PERMIT NUMBER:
PERMIT FEE: d 4(1 z),0
Residential
SITE ADDRESS: 1405 S Limerick
Building owner
DESCRIPTION OF WORK
# OF UNITS
Name: Dock
Phone:
Fax:
TOTAL AMOUNT
Address: SAME
City:
State:
Zip:
Contractor
56.00
=
Name: Norm's Excavating, Inc
Phone: 509/928-0580
Fax: 509/448-4906
Address: POBox30873
City: Spokane State:
WA
Zip: 99223
License No: NORMSEI972BM
City Business License No:
Contact
X
56.00
=
Name: Tina Lingo
Phone: 928-0580
SHOWERS (PER TRAP)
BATH, STALL ON-SITE BUILT
AUTHORIZED SIGNATURE:
REVISED 8/26/01
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
56.00
=
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
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
56.00
=
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
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
56.00
=
12
ROOF DRAINS/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
36,00
=
6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER. CHECK VALVE.
AND R.P.B_P.D. FOR: VATS, TANKS, BOILERS
X
56.00
=
16
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
Cara See fax cover
SUBTOTAL
6.00
El VISA 0 MASTERCARD
PROCESSING FEE
37.00
EXPIRES:
TOTAL PERMIT FEE DUE:
43.00
AUTHORIZED SIGNATURE:
REVISED 8/26/01