2012, 06-26 Permit App: BLD-2012-0974 Plumbing FixturesStiokane
Mil
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www ,pail: an _vnl I cy,onl co m
Plumbing Permit Application
SITE ADDRESS: _7902 E Liberty
Mail or Fax To:
Norm's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892-0432
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PERMIT NUMBER:
PERMIT FEE:
❑ Commercial ® Residential
Building owner
DESCRIPTION OF WORK
Name: Ackerman
Phone: 924-0245 Fax:
COST
Address: SAME
City: State:
Zip:
Contractor
WATER CLOSET, BIDETS
Name: Norm's Excavating, Inc
Phone: 509/928-0580
Fax: 509/892-0432
Address: PO Box 574
City : Veradale State: WA
Zip: 99037
LicenseNo: NORMSEI972BM
City Business License No:
X
Contact
=
Name: Sheila Gibbons
Phone: 928-0580
AUTHORIZED SIGNATURE: ` 1 ` i L.
E • d 2E41126RE❑S 2uz4eneox3 swuo.
REVISED 8/26105
eL : GO 21 90 unC
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
56.00
=
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, F000, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
$8.00
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
=
12
ROOF GRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
1
X
$6.00
=
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
$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
$6.00
=
21
PRIVATE SEWAGE DISPOSAL/SYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK ® VISA 0 MASTERCARD
rnr.rx cee r..,.er char EXPIRES:
SUBTOTAL
6.00
PROCESSING FEE
8.00
TOTAL PERMIT FEE DUE:
14.00
AUTHORIZED SIGNATURE: ` 1 ` i L.
E • d 2E41126RE❑S 2uz4eneox3 swuo.
REVISED 8/26105
eL : GO 21 90 unC