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2014, 10-09 Permit App: APR-214-0106 Approachcm• of Spokane. jValleyY Project #ArQ' I (42.7 n 10(0 RECEIVE Community Developme5t�$ep r en�os Permit Center II 11703 East Sprague Avenue, Suite B-3 SpoksneValleyr9H0E6RMIT CENTER Tel: (509)720-520 Faxit¢$$ r7 perm:cits evall v.olig REV. _ (Staff Use Only) PERMIT NUMBER: PERMITFEE: APPROACH PERMIT APPLICATION PROJECT ADDRESS: § 3 b( AD 14 0 L. o Ai START DATE: /D - 9 - 02o / y I ANTICIPATED COMPLETION DATE: BUILDING OWNER NAME: L. -A)I,.- L, (40 PK es 1. LC. MAILLNG ADDRESS: 0- t t )• J N O P i 5 I. i CITY: 0 ki- /L) �)/}C/2 t� STATE: x)4 • CONTACT PERSON NAME: • le e I u- p e- r PHONE: ('j C9 q aq- La 1 I FAX: roc, O ) / Z/ -alp 5 CELL: / 9 -o20f5- � �. 3o& ZIP: CONTRACTOR NAME: MAILING ADDRESS: C2 f D /U • a iu' ' J s f 1 c . 4 3-0-v CITY: 590 kA-AJc OdOddle_ Li STATE: ZIP: 7 /�7 o PHONE: (5-09) I a II ' l a- l / FAX: (-5 e 9) 9 a - O l 9 .5 CELL: CONTRACTOR LICENSE #: EXPIRES: CITY BUSINESS LICENSE #: 4 Residential Driveway I] Existing Curb & Gutter Culvert Installation I] Other Conditions: PROJECT DESCRIPTION (Please Provide Site Sketch) 0 Commercial/Industrial Driveway Rural Road Section 0 Sidewalk Repair/Construction Bond/Insurance certification must be on fele witis 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 DE -001: V-1 Date: 1O — `— \ Page 1 of 2