2015, 08-21 Permit App: ROW-2015-0591 ROW Community Development Department
Permit Center (Staff Use Only)
CITY11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206 PERMIT NUMBER:
kane Tel: (509) 688-0036
a11ey� Fax: (509) 688-0037 PERMIT FEE:
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RIGHT OF WAY (ROW) PERMIT APPLICATION
0 APPROACH 0 PAVEMENT CUT (SEE BELOW) : SIDEWALK
ID CURB & GUTTER D WORK THROUGH MANHOLE OTHER
ROAD OBSTRUCTION f NO [SES (if yes, complete the following)
• % of street or # lanes that will be obstructed:
• Length of time street will be obstructed:
b If work closes more than 50% of a local access street, or closes any portion of an arterial street,
then a TRAFFIC PLAN IS REQUIRED 0 Pre-Approved TCP Proposed:
PROJECT ADDRESS: ,23 D i S ",4,v7 S PARCEL NUMBER: 44-3-12.6,/, /6•51-3
APPLICANT'S JOB #: a zs LOCATE TICKET #
START DATE: y—.24,4 —/r ANTICIPATED COMPLETION DATE: f— '—
PROJECT DESCRIPTION:
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64'7s i2 --- " e i-E� 0'J
F c 2 piIczp L c7.= 7 S T -U.JT.4/n��7L-n/
PROPERTY OR BUILDING OWNER INFORMATION (IF APPLICABLE)
NAME: *6AN G-0y �� �7f?L' L`-� Cco
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MAILING ADDRESS: "t- / A,O' 13/el,' CITY: S�J /44 ✓,41//eco STATE: L✓A ZIP: %9:206
PHONE: (S-0 I) 90 'O FAX: f CELL: r_
CONTRACTOR INFORMATION /
NAME: /22fc-17, e ! 7 JiGh
MAILING ADDRESS: 2 2 S. r6-7)4,- S CITY: (7:Z72,4714 L(2' STATE: `14 ZIP: ci;10..7 7
PHONE: CJ v j)..773 S 7 FAX: CELL:
CONTRACTOR LICENSE NO.: EXPIRES: CITY BUSINESS LICENSE NO.:
BOND/INSURANCE CERTIFICATE # (per SVMC Title 10, Article 2):
CONTACT NAME: PHONE:
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**** IF PAVEMENT CUT, COMPLETE THE FOLLOWING ****
NATURE OF WORK: Gas Electric Water CAN Communication Sewer Other
(circle one)
TYPE OF CUT/REPAIR: Asphalt Gravel Concrete Other
(circle one)
SIZE OF CUT
(width) x (length)
STAFF TO COMPLETE:
ROAD TIER: PAVEMENT CUT POLICY APPLIES?
DISCLAIMER
The permitted verifies,acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling,the dwelling is/will
be served by potable water. 2)Ownership of this City of Spokane Valley permit inures to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws,codes or ordinances. 6) Plans or additional
information may be required to be submitted and subsequently approved before this application can be processed.
EXPIRATION
Right-of-way permits issued between April 1' and September 30th are valid for 30 days after the date of issuance, with a one-time 30-day
extension available. Right-of-way permits issued between October 1'and March 31'are valid until the following April 30th
Applicant Signature: /cal,/ ( -"1
ix
Method of payment: ❑ Cash ❑ Check ❑ Visa** El Mastercard**
** If paying with credit card, the City will call for credit card information when the permit is ready to be issued.
PLEASE FAX TO CITY OF SPOKANE VALLEY (509) 688-0037 UPON COMPLETION
ROY-Z%Sr-pS 4
77
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PRED CONSTRUCTION
404 N. Pines Rd. Ste D, Spokane Valley, WA 99206
Licensed and Bonded Contractor's # PREDLL*854LC
Contact Dan @ (509) 290-0925
"ON TIME AND ON BUDGET"
August 21, 2015
Rale-70/P-05-4
City Of Spokane Valley 77i
Permit Center
Attn: Patrick Barclay, EIT
Re: Blocking Plan for Obstruction Permit at 2309 S . Adams RD
Patrick,
I propose a hose-protecting / ramp style set of 2" x 6", fastened
atop 2" x 12", douglas fir dimension lumber to straddle both
sides of the water hose, extending from the western curb of Adams
Rd to the eastern shoulder of Adams Rd in a perpendicular
fashion. Both sets of ramps are to be held together by
construction grade plumber' s tape and 1. 5", #6 wood screws .
The following drawing shows the location of the ramps, hose,
safety cones, and signage.
A = "Road Work Ahead" signage
B = "Motorcycles Use Extreme Caution" signage
C = "Bump" signage
D = Safety Cones
A Avon s RI)
'4r1b ckda, ¢ /r /NORTH
C
Comcacr• het
jiRe I--( a..6."Jr
Rww►P
IlAmP
D
Thank you,
Dan Coyle-
PRED
oylePRED Construction C
15 we -S I r