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2012, 06-26 Permit App: BLD-2012-0980 Plumbing Fixtures
EiPiararte 1Malley Community Development Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 skan.vall.v.nre.ccnn Mall or Fax To: Norm's Excavating, Inc PO Box 574 Veradale, WA 99037 Fax 892-0432 008 '°N Plumbing Permit Application n Commercial SITE ADDRESS: _15015 E Longfellow WOVE 6[06 '96 'unr p1Ai131 AD•2t>12.64g0 PERMIT NUMBER PERMIT FEE: 32r D 0 Residential Building owner DESCRIPTION OF WORK Name: Tuttle Phone: 922-1517 Fax: COST Address: SAME City State: Zip: Contractor WATER CLOSET, BIDETS 1 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: NORMSE1972BM City Business License No: X Contact = Name: Sheila Gibbons Phone: 928-0580 AUTFIORIZED SIGNATURE: , I'd 2E.17026B60S ui�eneox3 SWJOI.I REVISED B/26/05 eTO:OT 21 92 unC DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X 86.00 = 6.00 2 URINALS X $6.00 = 3 TUBS X 86.00 = 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 86.00 = 6.00 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 6 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X 86.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X 86.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS, DRINKING X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X $6.00 = 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 $6.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00. = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK Card See Cover Sheet (0 VISA 0 MASTERCARD EXPIRES: SUBTOTAL 24.00 PROCESSING FEE 8.00 TOTAL PERMIT FEE DUE: 32.00 AUTFIORIZED SIGNATURE: , I'd 2E.17026B60S ui�eneox3 SWJOI.I REVISED B/26/05 eTO:OT 21 92 unC