2011, 10-25 Permit App: 11003399 ROW, Plumbing FixturesjValley
Community Development
Plumbing Permit
SITE ADDRESS:
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
w•wwspokaneva1ley.ore,, com
Application
8011 E Marietta
Mail or Fax To:
Norm's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892-0432
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PERMIT NUMBER:
PERMIT FEE:
El Commercial ® Residential
Building owner
Name: Hartmeicr
Address: SAME
Contractor
Name: Norm's Excavating, Inc
Address: PO Box 574
License No: NORMSE1972BM
Contact
Name: Sheila Gibbons
Phone: 928-7785
City:
Phone: 509/928-0580
City : Veradale
State:
State: WA
City Business License No:
Phone: 928-0580
Fax:
Zip:
Fax: 509/892-0432
Zip: 99037
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AUTHORIZED SIGNATURE:
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REVISED 8/26105
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OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
DESCRIPTION
WATER CLOSET, BIDETS
X
$6.00
=
1
TOILETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
4
5
SHOWERS (PER
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
X
$6.00
=
6
DISHWASHER
WASHER
X
$6.00
=
7
CLOTHES
DISPOSAL
X
$6.00
=
8
9
GARBAGE
WATER SOFTENER
X J
$6.00
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
10
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
FOUNTAINS, DRINKING
X
$6.00
=
1 13
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
=
1
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
=
1
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:
❑ CASH 0 CHECK el VISA ❑ MASTERCARD
, _ _ - ,._ _ _. cvnracc
SUBTOTAL
6.00
PROCESSING FEE
TOTAL PERMIT FEE DUE:
6.00
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AUTHORIZED SIGNATURE:
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2UlleneoxR SWJOM
REVISED 8/26105
ef2:60 II SZ 400