2012, 05-03 Permit App BLD-2012-0552 Plumbing Fixturesrnr��
Valley
Community Development
Plumbing Permit
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www. sp o k a n eva 1 I cv. o r 9. c o m
Application
Mail or Fax To:
Norm's Excavating, Inc.
PO Box 574
Veradale, WA 99037
Fax: 892-0432
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❑ Commercial
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PERMIT NUMBER_
PERMIT FEE: a 9 , 00
® Residential
SILLAULZU.UJ: _I/LJ L Juv..uv..
Building owner
Phone: 926-5764 Fax:,
Name: Bohr
Zip:
Address: SAME City. State:
Contractor
509/892-0432
Phone: 509/928-0580
Name: Norm's Excavating, Inc
Fax
99037
City : Veradale State: WA
Address: PO Box 574'
Zip:
City Business License No:
License No: NORMSEI972BM
Contact
Name: Sheila Gibbons Phone: 928-0580
WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
DESCRIPTION OF
WATER CLOSET, BIDETS
1
X
$6.00
=
6.00
1
TOILETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
1
X
$6.00
=
6.00
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
-
5
SINKS
i.AVS/BASINS, BAR, FLOOR. KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
1
X
$6.00
_
6.00
X-RAY, FOOD. PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
'
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
TANK
NOTE: IF GAS. SEE MECHANICAL
X
$6.00
=
10
ELECTRIC HOT WATER
X
$6.00
=
AREA, CASE, COIL, TRENCH. CONDENSATE
11
FLOOR DRAINS
ROOF DRAINS/OVERFLOW
X
56.00
=
12
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
WATER PIPING/DRAIN-IN WASTE,
NSTALLATIOPAIR,
1
X
$6-00
=
6.00
REVERSAL
REVERSALS�ION'
14
VENT, PLUMBING,
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
`
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
X
56.00
=
PROOFER, CARBONATOR, SWAMP COOLER
VACUUM BREAKER, CHECK VALVE.
X
$6.00
=
DEVICE
AND R.P.B.P.D. FOR: VATS, TANKS. BOILERS
17
CROSS CONNECTION
GREASE TRAP, SAND TRAP,
X
_
18
INTERCEPTORS
CHEMICAL HOLDING TANK
X
$6.00
NITROUS, OXYGEN
19
MEDICAL GAS (par outlet)
MISCELLANEOUS PLUMBING
X
g6,Op
=
20
FIXTURE
X
$20.00
=
21
PRIVATE SEWAGE DISPOSAL/SYS
INDUSTRIAL WASTE
X
515.00
=
22
INTERCEPTOR
SUBTOTAL
24.00
METHOD OF PAYMENT:
PROCESSING
FEE
37.00
El CASH L] CHECK El VISA ❑ MASTERCARD
EXPIRES:
TOTAL
PERMIT FEE DUE:
61.00
AUTHORIZED SIGNATURE:
lac. Q' i .clC`P 7/_.
REVISED 8/26105
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