2012, 03-01 Permit App: BLD-2012-0072 Piping Mai
" Norm'sExcavating,
ing,Inc. r 6 9 0N W V H ,U 61.H
1.O ` s uu 1 P
a n i a,a
PO Box 574
Veradale,Center Veradale,WA 99037
11707E Sprague Ave,Suite 106 Fax:892-0432 2
Spokane Valley,WA 99206 PERMET NUMBER: 13(tf- 1 Z-7
(509)688-0036 FAX:(509)688-0037 PERMIT P:✓. /1.--/ ,,,,,),
Community Development www.spokancvalicv.org.com
Plumbing Permit Application ❑ Commercial El Residential
SITE ADDRESS: 14812 E Rockwell
Building owner
Name: Peters Phone: 979-3399 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 Pbone: 928-0580
DESCRIPTION OF WORK #OF UNITS _X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6.00 =
2 URINALS X $6.00 =
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3 TUBS X '
$6.00 =
4 SHOWERS(PER 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 DISI-WASHER X $6.00 =
7 CLOTHES WASHER X $8.00 =
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 $600 =
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.O.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:
6.00
PROCESSING FEE
0 CASH 0 CHECK ® VISA 0 MASTERCARD
Card# See fax cover EXPIRES: 03/2012 TOTAL PERMIT FEE DUE: 6.00
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AUTHORIZED SIGNATURE: ---_.._--- .:-" 6 (774,/47./e.
REVISED 8/26/05
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