HomeMy WebLinkAbout2003, 07-03 Permit App: ROW-03-00439 ApproachAPR 29 2003 16:48 FR
Spoc"kane
TO 12087624507 P.05/05
Cali 24 hours before inspection required
Phone 509.688-0036 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Permit # PW
APPROACH PERMIT
APPLICATION
Location of property t k `3
Applicant Name—V
` ddres !Parc #L if avail le}
Address. 4U DC 11) . ac) L " ` Ph ne L --u 1 D L
Contractor's Name V
Address Phone
Contractor's Reg# V t V L t oiBB Expires Ii
PROJECT DESCRIPTION (Provide site sketch)
nResidential Driveway L_J Commercial/Industrial Driveway
E Existing Curb & Gutter 17 Rural Road Section
nCulvert Installation
Other conditions
n Sidewalk Repair/Construction
See construction requirements and details on reverse. Bond/insurance certification must be on
file with the C.
SPECIAL CONDITIONS:
PERMIT FEE $_ inspection Fee$
1 hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card # Expiration Date
Name of Holder Signature
Fees Paid$ Date !nit
** TOTAL PAGE.05 **
ol`.lroe�r,,/,^," e wry
) 11707 E. SPRAGUE, STE 106
00 Valley SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
PROJECT TRANSMIJ JAL:
TRANSMITTAL DALE:
SITE INFORMATION PERMIT INFORMATION
Site Address: I S Be -t --
Parcel Number:
Subdivision:
Block: Lot:
Zoning: Water Dist:
Owner:
Address:
Building Inspector:
Permit Number:
Permit Use:
Applicant:
Contact:
Contractor:
Issue Date:
Phone:
Phone:
Setbacks — Front: Left: Right: Rear:
APPROVALS
BUILDINGS: (moi 7/Y
PLANNING:
ENGINEERS: "0 3— 4 ci
SC -44121437 WER
.9
0
FIRE LS•1;
ll