2012, 07-11 Permit App: APR-2012-0039 ApproachSpokane
Valley.
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B -3
Spokane Valley, WA 99206
Tel: (509) 720 -5240
Fax: (509) 688 -0037
permitcenter@spokanevallev.org
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APPROACH PERMIT APPLICATION
PROJECT ADDRESS:2509 S. BALFOUR RD.
START DATE:7 /11/2012
ANTICIPATED COMPLETION DATE: 7/12/2012
BUILDING OWNER NAME:JIM SAKAMOTO
MAILING ADDRESS: 2509 S. BALFOUR RD.
CITY: SPOKANE VALLEY
CONTACT PERSON NAME: JIM SAKAMOTO
STATE:WA ZIP: 99206
PHONE:509- 432 -4049
FAX: CELL:
CONTRACTOR NAME: INLAND ASPHALT COMPANY
MAILING ADDRESS: PO Box 3366
CITY: SPOKANE lz t, ,,1th. \\*) STATE:WA ZIP:99220 -3366
PHONE:509 -534 -2657 4_,64°` r145( (f FAx :509 -536 -3137 CELL:
CONTRACTOR LICENSE #:INLANAC9840K EXPIRES:9 /12/12 CITY BUSINESS LICENSE #:00612
(ZI Residential Driveway
❑ Existing Curb & Gutter
❑ Culvert Installation
❑ Other Conditions:
PROJECT DESCRIPTION (Please Provide Site Sketch)
❑ Commercial/Industrial Driveway
❑ Rural Road Section
❑ Sidewalk Repair /Construction
Bond/Insurance certification must 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 required to be submitted and subsequently approved
before this application can be processed.
Signature
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Date: 7/11/12
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