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2012, 10-16 Permit App: BLD-2012-1833 Piping
• 1 Permit Center 11707 E Sprague Ave, Suite 106 sValley Spokane Valley, WA 99206 ® (509)688-0036 FAX: (509)688-0037 Community Development tvoic.spokanevaller ure.com Plumbing Permit Application Mall or Fax To: Norm's Excavallng, Inc PO Box 574 Veradale, WA 99037 Fax: 892-0432 lLtU '°N WUEE:8 ZLa '9L 'PO awH. PaAia3a� PERMIT NUMBER: r3 (d -(1- PERMIT FEE: N 05<- n Commercial ® Residential - le 33 SITE ADDRESS: 12802 E Maxwell Building owner DESCRIPTION OF WORK # OF UNITS Name: Fuller Phone: 499-5080 Fax: TOTAL AMOUNT 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 Stale: WA Zip: 99037 License No: NORMSEI972BM City Business License No: Contact X 56.00 = Name: Sheila Gibbons Phone: 928-0580 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT AUTHORIZED SIGNATURE: 2•d 2Eb02GHG0S 2ut3ene0x3 sw-Jo)4 REVISED S/2695 e12=60 21 91 100 DESCRIPTION OF WORK # OF UNITS X COST TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 2 URINALS X 56.00 = 3 TUBS X 56.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X 56.00 = 5 SINKS LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY. UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT X 56.00 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X 56.00 = e GARBAGE DISPOSAL X 56.00 = 9 WATER SOFTENER X 56.00 = 10 ELECTRIC HOT WATER TANK NOTE' IF GAS, SEE MECHANICAL X 56.00 = 11 FLOOR GRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X 56.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS, DRINKING X 56.00 14 WATER PIPING/DRAIN-IN WASTE, VENT PLUMBING, REVERSAL NSTALIATION, ALTERATION, REPAIR, REVERSALS 1 X 56.00 = 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 56.00 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B P.D. FOR: VATS, TANKS, BOILERS X 56.00 = 16 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 56.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X 56.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE OISPOSALJSYS X 520.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X 516.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK ® VISA 0 MASTERCARD Card# See Cover Sheet EXPIRES: SUBTOTAL 6.00 PROCESSING FEE 37.00 TOTAL PERMIT FEE DUE: 43.00 AUTHORIZED SIGNATURE: 2•d 2Eb02GHG0S 2ut3ene0x3 sw-Jo)4 REVISED S/2695 e12=60 21 91 100