2006, 08-14 Permit App: 06003173 Plumbing Fixtures, ROWAug 11 06 10:02a NORMS EXCAVATING
•
kane
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Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Vir/d-CO Permit # Account # 000122
Location of property
ROW CONSTRUCTION PERMIT
111114% F i
(Address/Parcel #, if available)
Applicant Name i'J T 0 5 yA)
Address
Same Fax
Contractor's Name Norm's Excavating. Inc.
Address PO Box 574 Veradale. WA 99037 Phone 509/928-0580
Contractor's Reg# NORMSEI97ZBM Expires 01/14/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
• Driveway
ID Gas Installation/Repair
n Sidewalk Repair/Construction
x Sewer Connection
nCurb & Gutter
n Cable/Conduit/Pole
n Other
Pavement Cut
Dimensions
Bond/insurance certfication 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 GRIbons Signature
Fees Paid$ 16.00 $25.00
Date
Init
(Application) (Inspection)
In addition to the permit application fee of $16.00 (utility) or 325.00 (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
AUG 11 2006 10:12
509 892 0432 PAGE.03