2012, 05-03 Permit App: BLD-2012-0554 Plumbing FixturesC,11'A
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Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development vnrtiv.spokanevallev.orR.coin
Plumbing Permit Application
SITE ADDRESS: _4711 N Mayhew
Building owner
Name: Hall
Mail or Fax To:
Norm's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892-0432
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❑ Commercial ® Reside
Phone: 924-6217
Address: SAME
Contractor
Name: Norm's Excavating Inc
City:
Phone: 509/928-0580
City : Veradale
Fax:
State:
Zip:
Fax: 509/892-0432
State: WA 1 Zip: 99037
Address: PO Box 574
License No: NORMSEI972BM
City Business License No:
Contact
Name: Sheila Gibbons
Phone: 928-0580
DESCRIPTION OF WORK
1
2
3
4
TOILETS
WATER CLOSET, BIDETS
URINALS
TUBS
# OF UNITS
1
X
X
X
COST
56.00
56.00
•
TOTAL AMOUNT
X
56.00
5
SHOWERS (PER TRAP)
SINKS
6
7
8
9
10
11
12
13
14
15
16
DISHWASHER
BATH, STALL, ON-SITE BUILT
1
X
56.00
LAVSIBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY. JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
56.00
X
$6.00
CLOTHES WASHER
X
56.00
GARBAGE DISPOSAL
WATER SOFTENER
X
56.00
X
56.00
ELECTRIC HOT WATER TANK
FLOOR DRAINS
ROOF DRAINS/OVERFLOW
DRAINS
NOTE: IF GAS, SEE MECHANICAL
X
56.00
AREA, CASE, COIL, TRENCH, CONDENSATE
X
56.00
x
56.00
FOUNTAINS, DRINKING
X
56.00
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
SEWAGE EJECTOR
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
1
X
$6.00
•
6.00
WATER USING DEVICE
17
18
19
20
21
22
CROSS CONNECTION DEVICE
INTERCEPTORS
GRINDER, SUMP PUMP
X
56.00
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56.00
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6.00
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
MISCELLANEOUS PLUMBING
FIXTURE
PRIVATE SEWAGE DISPOSAUSYS
INDUSTRIAL WASTE
INTERCEPTOR
X
X
56.00
$20.00
X
515.00
s
METHOD OF PAYMENT:
❑ CASH 0 CHECK
Card# See Cover Sheet
AUTHORIZED SIGNATURE:
d
VISA ❑ MASTERCARD
EXPIRES:
-7%�l/Grrl,
7PI117PC2 FIC
SUBTOTAL
6.00
PROCESSING FEE
8.00
TOTAL PERMIT FEE DUE:
14.00
REVISED 8126/05
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