HomeMy WebLinkAbout2012, 08-28 Permit App: BLD-2012-1439 PipingSpokane
�`al7ey
Community Development
Plumbing Permit Application
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Mail or Fax To' ^I
Norm's Excavating, Inc L 7 /On6 0N
PO Box 574
Veradale, WA 99037
Fax: 892-0432
1866:6 M) '06 1°V awil 13 /I! as
PERMIT NUMBER: CACI— — (Z'
PERMIT FEE: L 7 �1
❑ Commercial ® Residential
11-1 31
SITE ADDRESS: 18520 E Maxwell
Building owner
DESCRIPTION OF WORK
11 OF UNITS
Name: Thornton
Phone: 230-2113
Fax:
TOTAL AMOUNT
Address: SAME
City:
State:
Zip:
Contractor
5600
=
Name: Norm's Excavating, Inc
Phone: 509/928-0580
Fax: 509/892-0432
Address: PO Box 574
City: Vcmdale State:
WA
Zip- 99037
License No: NORMSEI972BM
City Business License No:
Contact
X
5600
=
Name: Sheila Gibbons
Phone: 928-0580
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
AUTHORIZED SIGNATURE:
ZEb0Z6860S
2ui3eAeox3 sw.JoH
REVISED 926/05
eET:60 ZT 8Z gnu
DESCRIPTION OF WORK
11 OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET BIDETS
X
5600
=
2
URINALS
X
56.00
3
TUBS
X
5600
=
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
X
$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, COIL TRENCH, CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
5600
13
FOUNTAINS. DRINKING
X
56 00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
1
X
5600
=
6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
5600
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE B18,
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
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
520 00
=
22
INDUSTRLLL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
Card# See Cover Sheet EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
37.00
TOTAL PERMIT FEE DUE:
43.00
AUTHORIZED SIGNATURE:
ZEb0Z6860S
2ui3eAeox3 sw.JoH
REVISED 926/05
eET:60 ZT 8Z gnu