2005, 03-25 Permit App: 05000914 ROW, Plumbing Fixtures, ReversalMar 17 05 10:38a NORMS EXCAVATING
Srneir�___a® �
galley
5098920432
Call 24 hours before inspection required
Phone 509.588-0195 Fax 509.685-0037
DEPARTMENT OF PUBLIC WORKS
p7
Anticipated start date 416105 Permit #
ROW CONSTRUCTION PERMIT
Location of property 13124 E. Desmet
(Address/Parcel #, if available)
Applicant Name Isaak
Address
Account# 000122
Same Fax 892-0482
Contractor's Name
Norm's Excavating, Inc.
Address PO Box 574 Veradale, WA 99037 Phone 5091928-0580
Contractor's Reg# NORMSEI972BM Expires 01/14107
McDESCRIPTION
I cI Sewer Connection
▪ Curb & Gutter
Cable/Conduit/Pole
0 Other
❑ Pavement Cut
(Provide site sketch or plan as necessary for clarity)
❑ Driveway
• Gan Installation/Repair
• Sidewalk Repair/Construction
Dimensions
Bond/insurance certification must be on file with the City. Bond # 103957298
Permittee Signature Approved
Date
I hereby authorize the City of Spokane Valley to Marge 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 unfit One -Call Notification Ticket # entered here
PERMIT MUST BE KEPT ON SITE
MAR 17 2005 10:48
5098920432 PAGE.07