2012, 03-23 Permit App: BLD-2012-0214 Piping Mar 23 12 09: 10a Norms Excavating 5098920432 P. 3
Mail or Fax To:
Norm's Excavating,Inc.
PO Box 574 h
", Permit Center Veradale,WA 99037 ULd ZO/2- _ Q '1-l6
S`"p'o"kane 11707 E Sprague Ave,Suite 106 Fax:892-0432
Y`!""``�' Spokane Valley,WA 99206 PENT NUMBER:
jr��J (509)688-0036 FAX:(509)688-0037 PEST FEE:. 3. 0 0
Community Development www.spokancval lev.org.corn
Plumbing Permit Application ❑ Commercial ® Residential
SITE ADDRESS: 15005 E Rockwell
Building owner
Name:Ulmer Phone:230-9025 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 X $6.00 =
2 URINALS _ X $6.00 _ =
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 DISHWASHERX $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 X $6.00 =
12 DRAINS ,
13 FOUNTAINS,DRINKING X $6.00
WATER PIPING/DRAIN-IN WASTE, NSTALLAT1ON,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 X =
20 FIXTURE
21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 —
INDUSTRIAL WASTE X $15.00 =
22 INTERCEPTOR SUBTOTAL
6.00
METHOD OF PAYMENT: PROCESSING FEE
0 CASH ❑ CHECK ® VISA ❑ MASTERCARD 37.00
Card# See Cover Sheet EXPIRES: TOTAL PERMIT FEE DUE: 43.00
AUTHORIZED SIGNATURE: ---.------- (
%'• +7 1A.6 ' fc -' REVISED8/26/05
Received Time Mar. 23. 2012 9: 34AM No, 6844