2005, 05-31 Permit App: 05001863 ROW, Plumbing ReversalE0.39ad Z2b0E6860S
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Call 21 hours hefore inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date 6/6/05 Permit #
ROW CONSTRUCTION PERMIT
Location of property 1105 N. Woodruff
(Address/Parcel #, if available)
Applicant Name - Echelharger
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 01114/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
n Driveway
n Gas Installation/Repair
n Sidewalk Repair/Construction
71 1
Sewer Connection
Curb & Gutter
Cable/Conduit/Pole
Other
Pavement Cut
Dimensions
Bondtinsurance certification must be on file with the City. Bond # 103957298
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 Dale 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)
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
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