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2011, 11-03 Permit App: 11003506 ROW, Plumbing Fixtures
Mall Fax • Norm' Excavating, ELZS ON AVE :Ol IIOZ 'c ',ON aiull paniaoa� Norm's Excavating,Inc. PO Box 574 Permit Center Veradale,WA 99037 Siiiikane 11707E Sprague Ave,Suite 106 Fax:892-0432 PERMIT NUMBER: Spokane valley,WA 99206 j�all - (509)688-0036 FAX:(509)688-0037 PERMIT FEE: Community Development wwwsnoklme%allcv..ore.com Plumbing Permit Application ❑ Commercial ® Residential SITE ADDRESS: 14811 E Rockwell Building owner Name: Gutterud Phone: 922-3966 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 _ #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET.BIDETS 1 X $6.00 = 6.00 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT 1 X $6.00 _= 6.00 LAVS/BASINS,BAR,FLOOR KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = 6.00 X-RAY,FOOD,PREP/CULINARY MEAT 1 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 DISPOSAL/SYS X $20.00 = INDUSTRIAL WASTE 22 INTERCEPTOR X $15.00 = SUBTOTAL METHOD OF PAYMENT: 24.00 PROCESSING FEE ❑ CASH 0 CHECK El VISA ❑ MASTERCARD Card#see cover sheet EXPIRES: TOTAL PERMIT FEE DUE: 24.00 AUTHORIZED SIGNATURE: • �, ,!,17-`,./,./.:(6' "- REVISED 8/26'05 2 -d 7E-1.n7RRanc 2u z aeneox1 SWJOLI BRF :nn TT Fn Aou