2005, 05-11 Permit App: 05001533 Plumbing Reversal, ROWApr 11 05 12:06p NORMS EXCAVATING
Skn�
Dalley
5098920432
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
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Anticipated start date 4/26/05 Permit #
ROW CONSTRUCTION PERMIT
Location of property 13221 E. Cataldo
(Address/Parcel #, it available)
Applicant Name Phipps
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 01/14/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
Sewer Connection n Driveway
Curb & Gutter n Gas Installation/Repair
x
Cable/Conduit/Pale
Other
Pavement Cut
Sidewalk Repair/Construction
Dimensions
Bond/insurance certification must be on file with the City. Bond # 103957298
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)
minimus. Permittee signature constitutes an agreement to these terns and provisions.
Work completed satisfactorily (Signed)
Permit not valid until One -Call Notification Ticket # entered here
RPR 11 2005 12:17
Date
PERMIT MUST BE KEPT ON SITE
5098920432 PRGE.07