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2012, 10-02 Permit App: BLD-2012-1711 PipingPermit Center Spokane 11707 E Sprague Ave, Suite 106 assoaelCDalley Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development ,‘ w.v .,pnkanevnllev.ole.com Plumbing Permit Application Mail or Fax To: None's Excavating. Inc. PO Box 574 Veradale, WA 99037 Fax 892-0432 0 -?o) 7-- '1 9810'°N WVL6:01 blob 130 awil pAl23aa PERMIT NUMBER: PERMIT FEE: n Commercial ® Residential SITE ADDRESS: _19222 E Mission Building owner DESCRIPTION OF WORK Name: Unice Phone: 926-5982 Fax, COST Address: SAME City: State: Zip: Contractor WATER CLOSET. BIDETS Name: Norm's Excavating, Inc Phone: 509/928-0580 Fav: 509/892-0432 Address: PO Box 574 City : Veradale State: WA Zip: 99037 License No: NORMSEI972BM City Business License No: X Contact = Name: Sheila Gibbons Phone: 928-0580 AUTHORIZED SIGNATURE: r/, z d E170a88GO9 UneAEOX3 SWJOI,J REVISED 11I26/05 eET:OT at Zo 4°o DESCRIPTION OF WORK # OF UNITS X COST a TOTAL AMOUNT 1 TOILETS WATER CLOSET. BIDETS X 5600 = 2 URINALS X 56.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X 36 00 = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT X 5600 = 6 DISHWASHER X 56.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X 5600 = 9 WATER SOFTENER X 5800 = 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 56.00 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X 5600 = 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 58.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 56.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X 56 00 = 20 MISCELLANEOUS PLUMBING FIXTURE X 5600 = 21 PRIVATE SEWAGE DISPOSAL/SYS X 520.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X 515.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK E1 VISA 0 MASTERCARD Card# See Cover Sheet EXPIRES: SUBTOTAL 6.00 PROCESSING FEE 8.00 TOTAL PERMIT FEE DUE: 14.00 AUTHORIZED SIGNATURE: r/, z d E170a88GO9 UneAEOX3 SWJOI,J REVISED 11I26/05 eET:OT at Zo 4°o