2005, 03-04 Permit App: 05000680 Plumbing Fixtures, ROWFROM : NORM'S EXCAUAT ING rHX NU. 'rJ7 07c rJtiJG
• •#\.,
*lane
."Valley
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS 3/3/05
Anticipated start date 3/16105 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 904 N. Ravine
(Address/Parcel #, if available)
Applicant Name Freid
Address Same Fax 892-0482
Contractor's Name Norm's Excavating, Inc.
Address PO Box 574 Veradale. WA 99037 Phone 509/928-05$0
Contractor's Reg# NORMSEI97213M Expires 01/14/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
riSewer Connection El Driveway
U Curb & Gutter El Gas Installation/Repair
U Cable/Conduit/Pole n Sidewalk Repair/Construction
Q Other
Pavement Cut
Dimensions
Bond/insurance certification must be on file with the Cit . Bond # 103957, •8,
SPECIAL CONDITIONS:
Permittee Signature Approved Date
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card # Expiration Date 09/30/05
Name of Holder Sheila Gibbons Signature
Foos Paid$ 16.00 $25.00
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 03 2005 12:16
509 892 0432 PAGE.20