2012, 11-20 Permit App: BLD-2012-2128 Plumbing FixturesSOkane
.0.015Vailey
Community Development
Plumbing Permit Application ❑ Commercial ® Residential
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokancvallcv.or°.com
Mail or Fax To:
Norm's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892-0432
zO\2—` 1
PERMIT NUMBER
PERMIT FEE:
to
SITE ADDRESS: 118 N McMillan
Building owner
DESCRIPTION OF WORK
it OF UNITS
Name: Fisher
Phone: 924-0074
Fax:
TOTAL AMOUNT
Address: SAME
TOILETS
City: State:
Zip:
Contractor
56.00
=
6.00
Name: Norm's Excavating, Inc
URINALS
Phone: 509/928-0580
Fax: 509/892-0432
Address: PO Box 574
56.00
City : Veradale State: WA
Zip: 99037
License No: NORMSE1972BM
TUBS
City Business License No:
Contact
$6.00
=
_
Name: Sheila Gibbons
SHOWERS (PER TRAP)
Phone: 928-0580
1
AUTHORIZED SIGNATURE:
2'd 2E17O26860S
UtleA OX3 SWJON
REVISED 826/05
eGO=TT ZT 02 AON
DESCRIPTION OF WORK
it OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
56.00
=
6.00
2
URINALS
X
56.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH. STALL, ON-SITE BUILT
1
X
56.00
=
6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR. PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
56.00
- =
6.00
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
56.00
=
8
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE.
VENT, PLUMBING, REVERSAL
NSTALLATION, 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
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAL/SYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH CICHECK la VISA CI MASTERCARD
Card# See Cover Sheet EXPIRES:
SUBTOTAL
24.00
PROCESSING FEE
37.00
TOTAL PERMIT FEE DUE:
61.00
AUTHORIZED SIGNATURE:
2'd 2E17O26860S
UtleA OX3 SWJON
REVISED 826/05
eGO=TT ZT 02 AON