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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 Wd9l :Ol 606 '96 'unr au/i . paA i apq e'kt-) 2 =i7- -c1 �-J 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