2005, 04-25 Permit App: 05001538 ROW, Plumbing Fixtures, ReversalApr 25 05 11:27a NORMS EXCAVATING
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5098920432
Ca11.24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
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Anticipated start date 5111105 ?? Permit #
ROW CONSTRUCTION PERMIT
Location of property 13119 E. Boone
Applicant Name Nichols
(Address/Parcel #, if available)
Account # 000122
Address Same Fax 892-0482
Contractor's Name Norm's Excavating. Inc.
Address PO Box 574 Veradale. WA 99037 Phone 509/928-0580
Contractor's Reg# NORMSEI972BM Expires 01114107
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
( X I Sewer Connection Driveway
Curb & Gutter 0 Gas Installation/Repair
Cable/Conduit/Pore
Other
Pavement Cut
ElSidewalk Repair/Construction
Dimensions
Bond/insurance certification must be an file with the City. Bond # 103957298
SPECIAL CONDITIONS:
Permittee Signature Approved
Date
1 hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card # Expiration Date 09/30/05
Name of Holder Sheila Gibbons Signature
Fees Paid$ 16.00
$25.00
Date
Init
(Application) (Inspection)
In addition to the permit application fee of $16.00 (utility) or $25.00 (construction), inspection on
each permit will be billed to the permittee at a rate of $50.00 per hour with a $25.00 (1/2 hour)
minimum. Permittee signature constitutes an agreement to these terms and provisions.
Work completed satisfactorily (Signed)
Date
Permit not valid until One -Call. Notification Ticket # entered here
PERMIT MUST BE KEPT ON SITE
APR 25 2005 11:38
5098920432 PAGE.03