2011, 10-18 Permit App: 11003318 ROW, Plumbing Fixtures.00,01FValley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
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Plumbing Permit Application
SITE ADDRESS: 7408 E Liberty
Mail or Fax To: � � 0 � 0
Norm's Excavating, Inc. N
PO Box 574
Veradale, WA 99037
Fax: 892-0432
WdlE:Ol 1106 '81. 'P0 aiuI1 IDA! D
PERMIT NUMBER:
PERMIT FEE:
D Commercial ® Residential
Building owner
DESCRIPTION OF WORK
Name: Compton
Phone: 842-2727
Fax:
Address: SAME
City: State: Zip:
Contractor
TOILETS
WATER CLOSET, BIDETS
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
$6.00
=
Name: Sheila Gibbons
Phone: 928-0580
TUBS
AUTHORIZED SIGNATURE:
'd 2E17112RRR1lq
2uiteneoxR stuJom
REVISED 8/26/05
ess:so II Bi 400
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
$6.00
=
6.00
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
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
$6.00
=
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
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
86.00
13
FOUNTAINS, DRINKING
X
86.00
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
ICEAN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
86.00
=
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 DISPOSAL/SYS
X
820.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
815.00
=
METHOD OF PAYMENT:
Cl CASH ❑ CHECK ® VISA 0 MASTERCARD
Card# see cover sheet EXPIRES:
SUBTOTAL
24.00
PROCESSING FEE
TOTAL PERMIT FEE DUE:
24.00
AUTHORIZED SIGNATURE:
'd 2E17112RRR1lq
2uiteneoxR stuJom
REVISED 8/26/05
ess:so II Bi 400