2012, 04-04 Permit App: BLD-2012-0296 Piping Apr 04 12 11 : 23a Norms Excavating 5098920432 p. 5
Mail or Fax To:
Norm's Excavating,Inc.
PO Box 574 n
" • ^ Pennit Center Veradale,WA 99037 61-o`Z C1 Z -42-q 6
Sjbbrkane ` 11707 E Sprague Ave,Suite 106 Fax:892-0432
PERMIT NUMBER
.000-Valley Spokane Valley,WA 99206
v (509)688-0036 FAX:(509)688-0037 PERMIT FEE: if- Cc
Community Development www.spokanevallev.org.com
Plumbing Permit Application ❑ Commercial ® Residential
SITE ADDRESS: _14407 E Valleyway
Building owner
Name: Rawlings Phone:218-9818 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 S OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6.00 =
2 URINALS X $6.00 =
3 TUBS X $800 =
4 SHOWERS(PER TRAP) BATH,STALL,ONSITE BUILT X $6.00 =
LAVSBASINS,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
❑ CASH 0 CHECK ,LISA D MASTERCARD 8.00
Cardfi See Cover Sheet EXPIRES: TOTAL PERMIT FEE DUE: 14.00
dolOr
AUTHORIZED SIGNATURE: f� ,1177/11,/Ver/c , REVISED 8/26/05
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
Received Time Apr. 4, 2012 11 :4 6 AM N o, 7035 pursuant to SOS DAN GS2014-030.