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2012, 02-27 Permit App: BLD-2012-0038 Plumbing FixturesFeb 21 12 10:25a n r.� . lley Community Development Plumbing Permit Application Norms Excavating Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevallev.org.corn SITE ADDRESS: 13621 E Longfellow OU i0 cu-r.:i Mail or Fax To: Norrn's Excavating, Inc. PO Box 574 Veradale, WA 99037 Fax: 892-0432 Z6I-003k PERMIT NUMBER: PERMIT I•'hh: Commercial ® Residential AUTHORIZED SIGNATURE: Received Time Feb. 21. 2012 9:51AM No. 6497 32.00 REVISED 8(26105 DESCRIPTION OF WORK # OF UNITS X COST Bonding owner Name: Salsbury Phone: 280-6162 Fax: 1 Address: SAME City: State: Zip: Contractor $6.00 = 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 TUBS Name: Sheila Gibbons Phone: 928-0580 56.00 - 4 AUTHORIZED SIGNATURE: Received Time Feb. 21. 2012 9:51AM No. 6497 32.00 REVISED 8(26105 DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X $6.00 = 6.00 2 URINALS X $600 3 TUBS X 56.00 - 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 56.00 a 6.00 6 DISHWASHER X $6.00 7 CLOTHES WASHER X $6.00 a 8 GARBAGE DISPOSAL X 58.00 = 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 a 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 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 a 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 $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAL/SYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X 515.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK ® VISA 9 MASTERCARD EXPIRES: 03/2012 SUBTOTAL 24.00 PROCESSING FEE & • Op TOTAL. PERMIT FEE DUE: 24.00 AUTHORIZED SIGNATURE: Received Time Feb. 21. 2012 9:51AM No. 6497 32.00 REVISED 8(26105