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2012, 05-24 Permit App: BLD-2012-0723 Plumbing Fixtures*blame jMiHey Permit Center 11707E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development www.spokanevallcv.org.com Plumbing Permit Application SITE ADDRESS: 8211 E Marietta Mail or Fax To: , Norm's Excavating, Inc. PO Box 574 Veradale, WA 99037 Fax: 892-0432 n ZL1Z-CMZ PERMIT NUMBER: PERMIT I- Eh: ❑ Commercial ® Residential AUTHORIZED SIGNATURE: - ,;<, (7/4",(0- ,e Received Time May. 24. 2012 9:41AM No, 7871 REVISED 826/05 DESCRIPTION OF WORK Banding X COST owner Name: Dinsmoor Phone: 590-7964 Fax: Address: SAME City: State: Zip: Contractor $6.00 = 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 TUBS Name: Sheila Gibbons Phone: 928-0580 $6.O0 = 4 AUTHORIZED SIGNATURE: - ,;<, (7/4",(0- ,e Received Time May. 24. 2012 9:41AM No, 7871 REVISED 826/05 DESCRIPTION OF WORK # OF UNITS X COST a TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X $6.00 = 6.00 2 URINALS X $6.00 3 TUBS X $6.O0 = 4 SHOWERS (PER 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 1 X $6.00 = 6.00 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 8 GARBAGE DISPOSAL X 56.00 = 9 WATER SOFTENER X 56.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6.00 = 11 FLOOR DRAINS AREA, CASE, COL, TRENCH, CONDENSATE X 56.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X 56.00 = 13 FOUNTAINS, DRINKING X 56.00 = 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 56.00 = 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 56.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X 56.00 a 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X 520.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X 515.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK ® VISA ❑ MASTERCARD EXPIRES: SUBTOTAL 18.00 PROCESSING FEE 8.00 TOTAL PERMIT FEE DUE 26.00 AUTHORIZED SIGNATURE: - ,;<, (7/4",(0- ,e Received Time May. 24. 2012 9:41AM No, 7871 REVISED 826/05