2012, 03-16 Permit App: BLD-2012-0158 Piping NoIIorFacaating,Inc. ESL9 '°N tvD :Ol ZIOZ 'Sl 'Am alui . p9AI909):I
PO Box 574
Permit Center Veradale,WA 99037 (JL..0 " 2.O 12- —01.5"R
n~ 11707 E Sprague Ave,Suite 106 Fax:892-0432 PERMIT NUMBER:
Walley Spokane Valley,WA 99206
(509)688-0036 FAX(509)688-0037 PERMIT FEE: 1 /t/ 0 e
Community Development w•w w_SpoI;ancvaIk v nr_cc m
Plumbing Permit Application ❑ Commercial ® Residential
SITE ADDRESS: 1219 N Rees
Building owner
Name:Levno Phone:926-2126 Fax:
Address: SAME City: State: Zip:
Contractor
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
Name: Sheila Gibbons Phone: 928-0580
DESCRIPTION OF WORK it OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET.BIDETS X $6.00 =
2 URINALS X $6.00 =
3 TUBS X $6.00 =
4 SHOWERS LER TRAP) BATH,STALL,ON-SITE BUILT X $6:00 =
LAVS/BASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT
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 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X $6.00 =
ROOF DRAINS/OVERFLOW
12 DRAINS X $6.00 =
13 FOUNTAINS,DRINKING X $6.00 =
WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR,
14 VENT,PLUMBING,REVERSAL REVERSALS 1 X $6.00 = 6.00
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
ICE AN/OR COFFEE MAKER,HOSE BIB,
16 WATER USING DEVICE STEAMER X $6.00 =
PROOFER,CARBONATOR,SWAMP COOLER
VACUUM BREAKER,CHECK VALVE,
17 CROSS CONNECTION DEVICE AND R.P.B.P.D.FOR: VATS,TANKS,BOILERS X $6.00 =
GREASE TRAP,SAND TRAP,
18 INTERCEPTORS CHEMICAL HOLDING TANK X $6.00 =
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 =
MISCELLANEOUS PLUMBING
20 FIXTURE X $6.00 =
21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 =
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT: 6.00
PROCESSING FEE
0 CASH 0 CHECK El VISA 0 MASTERCARD 8.00
Card# See Cover Sheet EXPIRES: TOTAL PERMIT FEE DUE: 14.00
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AUTHORIZED SIGNATURE: , 7 ./;/,' REVISED B/26/05
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