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