2008, 10-07 Permit App: 08003979 ApproachSpokane
.,.'Walley
Community Development
Permit Center
11703 E Sprague Ave, Suite B -3
Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
www.spokanevalley.org
Approach Permit Application
PERMIT NUMBER:
PERMIT FEE:
PROJECT ADDRESS 1 ;- 0 -5— ✓V i (re,
START DATE
V(
ANTICIPAI'ED COMPLETION DA "1'E
Building Owner:
Name: c/f4-ly% 16#►7f<
Address: 4.5.-q06 c f4
City: <yp -, sic, ri.g/Xi../
Phone_: /. _g` —ggqz/
Contact Person
tate: ,)A Zip:
Fax: g9/•- 9 ?:‘,69
Name: ,i74 is 77
Phone: 9`„ Tm
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other Conditions , /2 ve 7
Contractor:
Name:
Address: LD. .L]c x co
City: Je J j State: It?A- Zip:qqy '
Phone: 7/ Ocs/a r/ Fax:
Contractor Lic NoLnt-Xccerg iy Date:
City Business Lic. No: 60 6_ p+-
Commercial /Industrial Driveway
Rural Road Section
RECEIVED BY
CITY OF SPOKANE VALLEY
Sidewalk Repair /Construction OCT 0'7 2008
PERM ENTER
BY: �J
Bond /Insurance certification must be on file with the city.
DISCLAIMER
The permittee verifies, acknowledges and agrees by their signatures that: 1) If this permit is for construction of or on a dwelling, the
dwelling is /will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure 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) This 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.
Signature
Date /Q
Method of Payment
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN #:
Authorized Signature:
Effective October 28, 2007
P: \Community Development\Forms \Building forms\Approach Permit eff 10- 28- 07.doc
Project Numbef: 080193979 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/7/2008 Page 1 of 2
Project Information:
Permit Use: APPROACH
Setbacks: Front
Left: Right: Rear:
Site Information:
Plat Key: Name: Range
Parcel Number: 55182.1148
SiteAddress: 1205 N ARC ST
Location:: CSV
Contact: 3D EXCAVATION INC
Address: PO BOX 990
C - S - Z: NEWPORT WA 99156
Phone: (509) 447 -5419
Group Name:
Project Name:
INVCVMMOISUMM
District: East
Block:
Lot:
Owner: Name: NORTHERN KNIGHTS, LLC
Address: 11608 N WEST NEWMAN LAKE D
NEWMAN LAKE, WA 99025 -8639
Zoning: R -4 SF Res Urban Dis
Water District: 134 CONSOLIDATED I
Area: 4.11 Acres Width: 0
Nbr of Bldgs: 0 Nbr of Dwel
Review Information:
Review
Driveway /Approach
Permits: -. =m
Hold: ❑
Right Of Way (ft): 0
Released By:
Contractor: 3D EXCAVATION INC
Address: PO BOX 990
NEWPORT WA 99156
Item Description
APPROACH -CONST IN ROW
Approach
Firm: i?f EXCAVATION INC
Phone:
Units Unit Desc
1 NUMBER OF
Permit Total Fees:
(000) 000-0509
Fee Amount
$50.00
$50.00
Operator: JD Printed By: JD Print Date: 10/7/2008
Project Number: 080133979 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/7/2008 Page 2 of 2
A 6 -FOOT HIGH SIGHT - OBSCURING FENCE MUST BE INSTALLED AROUND PERIMETER
OF VALLEY COACH ESTATES SUBDIVISION PRIOR TO ANY BUILDING PERMITS -MH
Payment Summary: . ... -a : _ . r, .z :rte
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Approach $50.00 $50.00 $0.00 $50.00
$50.00 $50.00 $0.00 $50.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and /or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: JD Print Date: 10/7/2008
00
RECEIVED BY
CITY OF SPOKANE VALLEY
(CT 07 2008
5i- 43'
PERMIT TER