2010, 06-28 Permit App: 10001879 GradingSp61Cane
Valley
49;00
(Staff Use Only)
PERMIT NUMBER'
PERMIT FEE'
CITY OF SPOKANE VALLEY
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevalley.org
GRADING PERMIT APPLICA
(IMPROVEMENTS/LANDSCA
R.EC 1V�D
CSV PERMT CENTER
)JUN- 8 2010
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❑ ROUGH/CLEARING ® FULL GRADING ❑ UNDERGROUND ❑ SITE
SITE ADDRESS: 15401 E. 4.. AVE.
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
PROPERTY OWNER NAME:MR. BRENT ELLIOTT
MAILING ADDRESS:3306 BRUCE ROAD, SPOKANE WA 99206
MANAGER:MR. BRENT ELLIOTT
CITY: SPOKANE STATE: WA ZIP:99206
PHONE:362-2790 FAX: CELL:
CONTACT NAME:JOHN DELEO, PE
PHONE:370-5445 FAX: CELL:
EXCAVATION CONTRACTOR NAME: UNKNOWN AT THIS TIME
MAILING ADDRESS:
CITY: STATE: ZIP:
PHONE' FAX' CELL:
CONTRACTOR LICENSE NO.: EXPIRES: CITY BUSINESS LICENSE NO.:
COMPANY NAME:
MAILING ADDRESS:
CITY: STATE: Zip:
PHONE' FAX: CELL'
CONTRACTOR LICENSE NO.: EXPIRES: CITY BUSINESS LICENSE NO.:
Effective October 28, 2007 Page 1 of 2
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SOIL TESTING FIRM NAME:BUDINGER & ASSOCIATES, INC.
MAILING ADDRESS: 1101 N. FANCHER
CITY: SPOKANE VALLEY STATE:WA Zip:99212
PHONE:535-8841 FAX: CELL:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
ROAD (PAVING, CURB AND SIDEWALK) WATER SEWER & STORMWATER NEW CONSTRUCTION
ESTIMATED EXCAVATION/CUT (CUBIC YD):150
ESTIMATED EMBANKMENT/FILL (CUBIC YD):700
DESTINATION OF EXCAVATED MATERIALS:UN SITE
START DATEWNKNOWN ESTIMATED COMPLETION DATE:
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 Date:
Method of payment: ❑ Cash ❑Check
Bankcard #:
Authorized Signature:
®Visa ❑Mastercard
EXP: VIN#:
ec ive October 28, 2007
Page 2 of 2
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