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2012, 03-26 Permit App: BLD-2012-0215 Plumbing FixturesMar ed 1c ui:lua • I I U I- 111 •- ''-' o v a v- .. b Permit Center Sg kane 11707 E Sprague Ave, Suite 106 jVailey Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development www.spokanevallev.org.com Plumbing Permit Application SITE ADDRESS: 14512 E Longfellow Mail or Fax To: Norm's Excavating, Inc. PO Box 574 Veradale, WA 99037 Fax: 892-0432 64:4) - 2- C / - C Z-/ PERMIT NUMBER: PERMIT FEE: / ❑ Commercial ® Residential AUTHORIZED SIGNATURE: Received Time Mar. 23. 2012 9:34AM No.6844 REVISED 8126/05 DESCRIPTION OF WORK #OF UNITS X COST Building owner Name: Payne Phone: 891-6448 Fax: TOTAL AMOUNT 1 Address: SAME City: State: Zip: Contractor $600 = Name: Norm's Excavating, Inc Phone: 509/928-0580 Fax: 509/892-0432 Address: PO Box 574 City : Veradale Stale: WA Zip: 99037 License No: NORMSEI972BM City Business License No: Contact TUBS Name: Sheila Gibbons Phone: 928-0580 $6.00 4 AUTHORIZED SIGNATURE: Received Time Mar. 23. 2012 9:34AM No.6844 REVISED 8126/05 DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $600 = 2 URINALS X $6.00 = 3 TUBS X $6.00 4 SHOWERSEER 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 $6.00 = 6 DISHWASHER X $6.00 7 CLOTHES WASHER X $6.00 8 GARBAGE DISPOSAL X $6.00 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 13 FOUNTAINS, DRINKING X $6.00 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 $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 $6.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 _ 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X 56.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X 520.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK ® VISA 0 MASTERCARD Card* See Cover Sheet EXPIRES: SUBTOTAL 8.00 PROCESSING FEE 8.00 TOTAL PERMIT FEE DUE: 14.00 AUTHORIZED SIGNATURE: Received Time Mar. 23. 2012 9:34AM No.6844 REVISED 8126/05