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