2012, 08-21 Permit App: BLD-2012-1365 Piping_ Permit Center
s""" a, 11707 E Sprague Ave, Suite 106
ICY
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development ..,.„ L,,II;, ,. _tn,
Plumbing Permit Application nCommercial
Mail or Fac To: G C 0
Norm's Exavatng, Inc. 6176 N
PO Box 5'4
Veradalej WA 99037
Fax: 892-0432
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PERMIT NUMBER: 6 Icf —1Z -
PERMIT FEE: / LJ 00
Z Residential
SITE ADDRESS: _18605 E Mission
Building owner
Name: Doty
Phone: 998-2400
Fax:
Address: SAME
City:
State:
Zip:
Contractor
Name- Norm's Excavating, Inc
Prone: 509/928-0580
Fax: 509/892-0432
Address PO Box 574
City : Vemdale State.
WA
Zip. 99037
License No: NORMSE1972BM
City Business License No:
Contact
Name: Sheila Gibbons
Phoic 928-0580
DESCRIPTION OF WORK
k OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
2
URINALS
x
56.00
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, FOOD, PREP/CULINARY MEAT
X
56.00
6
DISHWASHER
X
56.00
7
CLOTHES WASHER
X
56.00
8
GARBAGE DISPOSAL
X
$6.00
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
$6.00
13
FOUNTAINS. DRINKING
X
56 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
$6.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, NOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56.00
17
CROSS CONNECTION DEVICE
18
INTERCEPTORS
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TAN S, BOILERS
GREASE TRAP, SAND T ,AP,
CHEMICAL HOLDING TANK
X
56 00
X
56 0D
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
5600
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑ CASH 0 CHECK
Cards See Cover Sheet
AUTHORIZED SIGNATURE:
E
0 VISA 0 MASTERCARD
EXPIRES:
dEb026B60S
SUBTOTAL
6.00
PROCESSING FEE
8.00
TOTAL PERMIT FEE DUE:
14.00
REVISED 8/26105
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