2013, 06-25 Permit App: APR-2013-0035 Widen Approach(IICITY OF ✓
pluane
'ley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B -3
Spokane Valley, WA 99206
Tel: (509) 688 -0036
Fax: (509) 688 -0037
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(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
AL0PROACH PIRh "ilET AP LIECATIDRI
PROJECT ADDRESS: /-T-11 % AJ
START DATE: ANTICIPATED COMPLETION DATE:
BUILDING OWNER NAME: Lill L. 1 -0 01cs L-LG
MAILING ADDRESS:
/, �/ /ley �v 2/�( /�)Cr� C' �/,
CITY J� >// /�4v /�lLL / STATE: /,(. // Zip: ! rW 6-,
CONTACT PERSON NAME:
PHONE:
410 €( //tJ /C /(____
FAX:
CONTRACTOR NAME: LjfJG /I/%%�, L-C _
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CELL: 6W---77g
MAILING ADD REESS :(` //f/ //G7(f/ ?)/ C 3
CITY: 5/fi )hat )hakr STATE: f/// ZIP: ; 0G.
PHONE: "02- 92V-/2/./ FA 2 X: 9 '(! / %7 CELL: 4-,99-, 7l! U
CONTRACTOR LICENSE NO.: // / /A� X
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/� 8 EXPIRES: 00/47 CITY BUSINESS LICENSE NO.:
PRO3ECT DESCRIPTION (Please Provide Site Sketch)
Residential Driveway El Commercial /Industrial Driveway
JJ Existing Curb & Gutter fl Rural Road Section
Culvert Installation f] Sidewalk Repair /Construction
fl Other Conditions:
Bond /Insurance certification roust be on file with the City.
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 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) 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 req l to be submitted and subsdfauentiy approved before thls application can be processed.
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Updated 1 -11 -11 Page 1 of 1
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