2012, 07-24 Permit App: BLD-2012-1180 Piping Fax
Norm' Excavating,
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Norm's Excavating,Inc.
PO Box 574
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Permit Center Veradale,WA 99037
Spokane 11707E Sprague Ave,Suite 106 Fax:892-0432 PERMIT NUMBER: 2 - I (6°
Valley Spokane Valley,WA 99206
�j (509)688-0036 FAX:(509)688-0037 .41
Community Development v,.wx,srol:,uic%,;ipey.orLI cool PERMIT FEB:
Plumbing Permit Application ❑ Commercial ® Residential p
SITE ADDRESS: _12908 E Sharp
Building owner
Name: Rumbaut Phone: 981-0404 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 TUBSX $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6.00 =
LAYS/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
D CASH 0 CHECK ® VISA 0 MASTERCARD 37.00
Cab# See Cover Sheet EXPIRES: I TOTAL PERMIT FEE DUE: 43.00 •
AUTHORIZED SIGNATURE: ' f REVISED R/26/05
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