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2012, 05-22 Permit App: BLD-2012-0707 Plumbing Fixtures
• jValky Comm unity Development Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www•.spokanevallev.orR_com • Plumbing Permit Application SITE ADDRESS: _12815 E Sinto Mail or Fax To:688L ON Norm's Excavating, Inc. PO Box 574 Veradale, WA 99037 Fax: 892-0432 0 Commercial WV88:6 6[06 '66.A IWII pania4 PERMIT NUMBER: PERMIT FEE: Residential Building owner Name: Kilgore Phone: 499-3883 Fax: Address: SAME Contractor City: State: Zip: Name: Norm's Excavating, Inc Address: PO Box 574 Phone: 509/928-0580 Fax: 509/892-0432 City : Veradale State: WA Zip: 99037 License No: NORMSEI972BM Contact City Business License No: Name: Sheila Gibbons Phone: 928-0580 AUTHORIZED SIGNATURE: �•d • �.,..._._._. j, _'I cal n?fRInq 2ut4eneox3 swuol REVISED 5/16105 881:60 21 22 ReW DESCRIPTION OF WORK # OF UNITS X COST o TOTAL AMOUNT TOILETS WATER CLOSET, BIDETS 1 X $6.00 = 6.00 1 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 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 1 X $6.00 = 6.00 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 _ 8 GARBAGE DISPOSAL X 86.00 = 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 = 12 ROOF DRAINS/OVERFLOW DRAINS X 86.00 = 13 FOUNTAINS, DRINKING X $6.00 _ 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X $6.00 = 6.00 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER X $6.00 _ 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X $6.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X 820.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK ® VISA ❑ MASTERCARD r= ten cm r .� S haoe EXPIRES: SUBTOTAL 24.00 PROCESSING FEE S7.00 TOTAL PERMIT FEE DUE: 61.00 AUTHORIZED SIGNATURE: �•d • �.,..._._._. j, _'I cal n?fRInq 2ut4eneox3 swuol REVISED 5/16105 881:60 21 22 ReW