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2008, 08-01 Permit App: 08002987 ApproachSCITI'OF 00� p6l&ne ,:,oOvalley Development Engineering 11707 E Sprague Ave Suite 106 ♦ Spokane Valley WA 99206 509.921.1000 ♦ Fax: 509.921.1008 ♦ cityhaLL@spokanevalley.org Approach Permit Application Review TO: Building Department Site Address: 19017 E. Montgomery Dr. Project No: 8-2987 Accepted Not Accepted Approach X Building Location Paved Access Notes: Date: Reviewed By: /r/� r ��'�' Project Number: 08002987 Inv: 1 Application Date: 8/1/2008 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Proiect Information: Permit Use: RESIDENTIAL APPROACH Contact: DAUGHERTY, JIM & SHEILA Address: 8316 E VALLEYWAY AVE C - S - Z: SPOKANE VALLEY, WA 99212 Setbacks: Front Left: Right: Rear: Phone: (509) 922-2385 Group Name: Site Information: Project Name: Plat Key: Name: Range District: East Parcel Number: 55082.0816 Block: Lot: SiteAddress: 19017 E MONTGOMERY DR Owner: Name: DAUGHERTY, JIM & SHEILA Address: 8316 E VALLEYWAY AVE Location:: CSV SPOKANE VALLEY, WA 99212 Zoning: R-4 SF Res Urban District Water District: 134 CONSOLIDATED ID #19 Hold: ❑ Area: 14,317 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Review Driveway/Approach Permits: Approach Contractor: STATELINE ASPLT PVNG & MNT Firm: STATELINE ASPLT PVNG & MNT Address: PO BOX 106 Phone: (509) 255-9175 LIBERTY LAKE, WA 99019 Item Description Units Unit Desc Fee Amount APPROACH -CONST IN ROW 1 NUMBER OF $50.00 Permit Total Fees: $50.00 Operator: JD Printed By: JD Print Date: 8/1/2008 Project Number: 08002987 Inv: I Application Date: 8/1/2008 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes: _., .. 08000709 requires a final inspection before we can sign -off on the title elimination for Megan at John Nees office - MT Payment Summary: ._ . 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 compiled 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: 8/1/2008 Scm,• Permit Center p -6 -lane 11703 E Sprague Ave, Suite B-3 ..;,.0`/0 ey Spokane Valley, WA 99206 "t (509)688-0036 FAX: (509)688-0037 Community Development www.gpokanevalleYnre Approach Permit Application PROJECT ADDRESS START DATE 2--I5 01' Al PERMIT NUMBER 2- PERMIT FEE: 14 a. DT s ANTICIPATED COMPLETION DATE �q5-: oAl 09 Name:.,T- m (Z Name: p a � © I Address: I f a QjY�+� �, Address: City: Q t Q QG State: et Zip: City eo State: 0Zip I . Phone: 509- Q3 _511Fax: Phone:5 Fax: -- 5 _. Contact Person -T TE / -3 /-20/0 tC itYBusiness tractor Lic No. Date: Name: Lic. No: a Phone PROJECT DESCRIPTION (Provide site sketch) Residential Driveway Existing Curb & Gutter Culvert Installation Other Conditions Bond/Insurance certification must be on file with the city. ❑ Commercial/Industrial Driveway Rural Road Section Sidewalk Repair/Construction 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 ls'9' ?I A64�� Method ofPaymenn ❑ Cash ❑ Check ❑ Mastercard Bankcard #: Expires: Authorized Signature: Date 9-3 Lt 1! ❑ VISA VIN#: Effective October 28, 2007 P:\Community DevelopmentWorms\Building fomis\Approach Permit eff 10-28-07.doc ❑ Other -bq- t n - -- -- - - -Cu,Q6 � Vin- fi pp gc.�. - co ► ll. &f 1"- - --- - ---- - -R©.m- e _ E 54.._T peiA-, L -v -- - - - - - �1� mess _ s--nc lei cn � m-- 5 , 19017 East Montgomery Drive Otis Orchards, Wa, 99027 Existing and Proposed Driveway Q Oitsomvn %% t�tyr ov �,�,-Dfm,Aci�iI &3-�11� 2 F i�h 1 L- ni t�