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2012, 10-02 Permit App: BLD-2012-1712 Plumbing FixturesPermit Center S"P kaR a 11707 E Sprague Ave, Suite 106 agog° Valley Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development 'vwn ymLancvallcv.mu cont Plumbing Permit Application SITE ADDRESS: _1812 N Mckee Ct Mall or Fax To. Norm's Excavating, Inc 8810'°N NV8 'Ol 6I06 'Z 130 anvil pato away PO Box 574 1) -in --701-7-1717 Veradale, WA 99037 Fax 892-0432 n Commercial PERMIT NUMBER: PERMIT FEE: Residential AUTHORIZED SIGNATURE: . ' r ' " / .r b'd 2E17028860S US2BAe0X3 SWJDI.J REVISED 8126/05 eS2=01 21 ZD goo DESCRIPTION OF WORK # OF UNITS Building owner COST = TOTAL AMOUNT Name: Wahl Phone' 481-7552 Fax' 1 Address: SAME $8.00 City: State: Zip: Contractor URINALS Name. Norm's Excavating, Inc $8.00 Phone: 509/928-0580 Fax: 509/892-0432 Address: PO Box 574 TUBS City • Veradale State: WA Zip: 99037 License No: NORMSEI972BM $6.00 City Business License No: Contact SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 1 Name: Sheila Gibbons $8 00 Phone. 928-0580 6.00 5 SINKS LAVS/BASINS, BAR, FLOOR. KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY FOOD, PREP/CULINARY MEAT 1 AUTHORIZED SIGNATURE: . ' r ' " / .r b'd 2E17028860S US2BAe0X3 SWJDI.J REVISED 8126/05 eS2=01 21 ZD goo DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET. BIDETS 1 X $8.00 = 8.00 2 URINALS X $8.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 1 X $8 00 = 6.00 5 SINKS LAVS/BASINS, BAR, FLOOR. KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY FOOD, PREP/CULINARY MEAT 1 X $6 00 = 6.00 6 DISHWASHER X $6 00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X $6.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6 00 -- 11 11 FLOOR DRAINS AREA CASE, COIL, TRENCH, CONDENSATE X $6 00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS, DRINKING X $600 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X $6.00 = 800 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE 613, 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 $6.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per oullet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAL/SYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK ® VISA 0 MASTERCARD ...cc. SUBTOTAL 24.00 PROCESSING FEE 37.00 TOTAL PERMIT FEE DUE: 61.00 AUTHORIZED SIGNATURE: . ' r ' " / .r b'd 2E17028860S US2BAe0X3 SWJDI.J REVISED 8126/05 eS2=01 21 ZD goo