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2012, 05-24 Permit App: BLD-2012-0722 Plumbing Fixturesrld`,J' GT 1.. Community Development Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www. spokaneval l ey.org. corn Plumbing Permit Application Mail or Fax To: Norm's Excavating, Inc. PO Box 574 Veradale, WA 99037 Fax: 892-0432 PERMIT NUMBER: PERMIT FEt: 0 Commercial ® Residential ontgome AUTHORIZED SIGNATURE: Received Time May. 24. 2012 9:41AM No. 7871 REVISED 8/26/05 DESCRIPTION OF WORK # OF UNITS X COST Building owner Name: LaFrace Phone: 926-1431 Fax: SAME City: State: Zip: Address: Contractor 56.00 = Name: Norm's Excavating, Inc Phone: 509/928-0580 Fax: 509/892-0432 Address: PO Box 574 City : Veradale State: WA Zip: 99037 License No: NORMSEI972BM City Business License No: Contact URINALS TUBS Name: Sheila Gibbons Phone: 928-0580 56.00 - 3 4 AUTHORIZED SIGNATURE: Received Time May. 24. 2012 9:41AM No. 7871 REVISED 8/26/05 DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT TOILETS WATER CLOSET, BIDETS X 56.00 = _ 1 X 56.00 2 URINALS TUBS X 56.00 - 3 4 SHOWERS (PER TRAP) BATH. STALL, ON-SITE BUILT X 56.00 =_ 5 SINKS LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT X $6.00 = 6 DISHWASHER X 56.00 = 7 CLOTHES WASHER X 56.00 = 8 GARBAGE DISPOSAL X 56.00 9 WATER SOFTENER X 56.00 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X 56.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE , X 56.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 13 FOUNTAINS, DRINKING X $'00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X 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 $6.00 = 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 56.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK ® VISA ❑ MASTERCARD EXPIRES: SUBTOTAL 6.00 PROCESSING FEE 8.00 TOTAL PERMIT FEE DUE: 14.00 AUTHORIZED SIGNATURE: Received Time May. 24. 2012 9:41AM No. 7871 REVISED 8/26/05