2005, 05-31 Permit App: 05001859 ROW, Plumbing Reversal, FixturesMay, 31 05 12:27p NORMS EXCAVATING
Spo°`kane
valley
5098920432
Call 24 hours before inspection required
Phone 509.688:0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
p.6
Anticipated start date 617105 Permit #
ROW CONSTRUCTION PERMIT
Location of property 9725E. Maxwell
Applicant Name Balmes
Address
(Address/Parcel #, if available)
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 01/14/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
Sewer Connection n Driveway
x
D Curb & Gutter
Cable/Conduit/Pole
in Other
Pavement Cut
Gas Installation/Repair
Sidewalk Repair/Construction
• Dimensions
Bond/insurance certification must be on file with the City. Bond It 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# 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 (112 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 if entered here
PERMIT MUST BE KEPT ON SITE
MAY 31 2005 12:40
5098920432 PAGE.06