2012, 05-31 Permit App: BLD-2012-0782 Pipingy_
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Permit Center
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Spokane 11707 E Sprague Ave, Suite 106
�MMlley
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development ww.s..J>nLannollev.oroccun1
Plumbing Permit Application
Norley Fax To.
Excavating,
6t6L NI NVZLLQL aLO lE' w 1 P a
Mail or Excavating, Inc. 0 /� 2 d lU 2 A 3 J 2
Veradale, WA 99037 �LdPO Box 574 0 o
Fax: 892-0432
PERMIT NUMBER:
PERMIT FEE: OW 00
[1 Commercial ® Residential
SITE ADDRESS: 18504 E Maxwell
Building owner
DESCRIPTION OF WORK
9 OF UNITS
X
Name: Battles
Phone:
926-0378
Fax:
TOILETS
Address: SAME
X
City: State:
Zip.
Contractor
2
URINALS
Name: Norm's Excavating, Inc
56.00
=
Phone. 509/928-0580
Fax: 509/892-0432
Address. PO Box 574
City : Veradale State: WA
Zip: 99037
License No: NORMSEI972BM
4
City Business License No.
BATH STALL. ON-SITE BUILT
Contact
X
86.00
=
Name: Sheila Gibbons
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, F00D. PREP/CULINARY MEAT
Phone: 928-0580
X
i
AUTHORIZED SIGNATURE: " "'r " •/"''`"'
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REVISED 826/05
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DESCRIPTION OF WORK
9 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
86.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, F00D. PREP/CULINARY MEAT
X
$6.00
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
86.00
8
GARBAGE DISPOSAL
X
56.00
9
WATER SOFTENER
X
5600
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE COIL, TRENCH, CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
86.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION. REPAIR.
REVERSALS
1
X
56.00
=
600
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
$6.00
=
18
INTERCEPTORS
GREASE TRAP. SAND TRAP,
CHEMICAL HOLDING TANK
X
$600
=
19
MEDICAL GAS (per outlet)
NITROUS OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
8600
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
0 CASH 0 CHECK 133 VISA 0 MASTERCARD
rnnlx C.. r..,,=r SAcal EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
8.00
TOTAL PERMIT FEE DUE:
14.00
i
AUTHORIZED SIGNATURE: " "'r " •/"''`"'
E"d ZEfOd6860S
9uiteneox3 SWJON
REVISED 826/05
e2T:OT 21 TE 6eW