2005, 03-17 Permit App: 05000913 ROW, Plumbing ReversalMar 17 05 10:38a NORMS EXCAVATING
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P Valley
5098920432
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
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£3 -)9 /5
Anticipated start date 415/05 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 13216 E. Desmet
Applicant Name Babin
Address
(Address/Parcel #, if available)
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 01114/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
Sewer Connection El Driveway
Curb & Gutter ❑ Gas Installation/Repair
I-1 Cable/Conduit/Pole Sidewalk Repair/Construction
Ti Other
x
Pavement Cut
Dimensions
Bondfinsurance certification must be on file with the City. Bond # 103957298
Permittee Signature Approved
Date
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card R Expiration Date 09/30/05
Name of Holder Sheila Gibbons Signature
Fees Paid$ 16.00 525.00
Date !nit
(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
MAR 17 2005 10:49
5098920432 PRGE.10