2005, 07-18 Permit App: 05002505 ROW, Sewer, Plumbing Reversal, Fixtures Jul 18 05 02:12p NORMS EXCAVATING 5098920432 P•5
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Mail or Fax To: Norm' s Excavating
Sane PO Box 574
�3� ey Veradale, WA 99037 1
FAX: 892-0432 I
PLUMBING PERMIT APPLICATION i,
l_ PERMIT
ADDIS: Cp e) 1.� b. 1/ USE i" i
PHONE(Daytime Contact): -?!n - 7U 94./OWNER: �./C�i1V J c O A.) •l'"
MAIUI+IO ADDRESS SAME (city/state) (uPZ ,,
(street) { ,
CONTRACTOR: UCF.NSE 1: B£LRNP*0 71 D ti i I i
Belknap Plumbing g',
PHONE :
NAILING ADDRESS: 'I '!
921 -5913 �;i,
fj
Verdale, WA 99037 [ I
3414 S. Adams Rd.
(street) (�P)(city/state) ,
PLUMIIt(NQ FIXTURES COSI
' DESCRrPTION MAILS s.1wort X
. MAU • AMOUNT li 1
WATER CLOSET.BIDETS X $6 - -.0 1 TOILETS � - X is -
2 URINALS
3 TUBS • X X $6 -Se ==
4 SHOWERS PER TRAP BATH,STALL ON-SITE BUILT X $6
5 SINKS LAVS19AS(NS,BAR.FLOOR, 0
KITCHEN.LAUNDRY,UTILRY,
JANITOR,PHOTO,X-RAY.FOOD, •
PREP/CULWARYJMEAT •
5 DISHWASHER _ X $6 X -
1 CLOTHES WASHER X $8 •
B GARBAGE DISPOSAL X $6 •
9 WATER SOFTENER 6 •
10 ELEC HOT WATER TANK NOTE:F GAS SEE MECHANICAL X $$
11 FLOOR DRAINS AREA.CASE,COIL,TRENCH, $6
X •
CONDENSATE ! ,
12 FOUNTAINS.DRINKING X X $6 s
13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERAnON, r �i OWASTE,VENT. REPAIR.REVERSALS f //o I
. . PLUMBING REVERSAL !
14 SEWAGE EJECTOR _GRINDER.SUMP PUMP X t6 I
15 WATER USING DEVICE R COFFEE HOSE BIB,STEAMER,MAKER. X $6ER,
GARSONATOR,SWAMP COOLER •
I
., €; I s
16 CROSS CONNECTION VACUUM BREAKER,CHECK
c r o r DEVICE VALVE,AND R.P.B.P.D.FOR:
2 VATS,SUMPS.TANKS,BOILERS •
c ; . X $25
8 o m v.. 17 SPRINKLER SYSTEM 2s
3 '' 0 18 INTERCEPTORS GREASE TRAP,SAND TRAP, • p
,, 36
E v c q CHEMICAL HOLDING TANK ' X
X -
▪ o: E r NITROUS,OXYGEN -
▪ c 3 N 19 MEDICAL GAS per outlet X $S •
'o? c 4° 20 MSC PLUMBING FIXTURE _ SUBTOTAL 111"111111 61-�,�� ;' I
z —
N ;v a,0 o �� 0 . PLUS PROCESSING .�r..QO �'.i
0 CASH CHECKj
_ d ° "' naxm rimers vas.dwar Ajoit r�Trot rwYrii>zvr FEE 1
° 75�' " °Pa'"�01�� TOTAL PERMIT FEE
. , N i
° 3 o DATE: y I -
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JUL 18 2005 14:24 5098920432 PAGE.05