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2008, 08-21 Permit App: 08003273 ApproachProject Number: 08003273 Inv: I Application Date: 8/21/2008 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: RESIDENTIAL APPROACH Contact: WILLIAMS CONCRETE Address: 17829 E WASHINGTON RD C - S - Z: VALLEYFORD WA 99036 Setbacks: Front Left: Right: Rear: Phone: (509) 928-6863 Group Name: Site Information: Project Name. Plat Key: 001705 Name: MOUNTAIN VIEW 04TH ADD District: Sout Parcel Number: 45274.0222 Block: Lot: SiteAddress: 13715 E 26TH AVE Owner: Name: FOUNTAIN, GLEN Address: 13715 E 26TH AVE Location:: CSV SPOKANE, VALLEY WA 99216 Zoning: R-3 SF Res District Water District: 010 VERA Hold: ❑ Area: .00 Acres Width: 95 Depth: 140 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 1 Review Information:,& IQ<C . r ..... .��� Driveway/Approach Released By: Originally Released: 8/21/2008 By: WMCGAV Permits:.,rp — - - Approach Contractor: WILLIAMS CONCRETE Firm: WILLIAMS CONCRETE SERVICE Address: 17829 E WASHINGTON RD Phone: (509) 928-6863 VALLEYFORD WA 99036 Item Description Units Unit Desc APPROACH -CONST IN ROW 1 NUMBER OF Permit Total Fees: Fee Amount $50.00 $50.00 Operator: jmm Printed By: jmm Print Date: 8/21/2008 Project Number: 08003273 Inv: I Application Date: 8/21/2008 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes: Payment Summary •,.. :::.... �$ .-. _ ._. s .. ,. w�x 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 complied 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: jmm Printed By: jmm Print Date: 8/21/2008 Spokcln >fPermit Center ane 11707 E Sprague Ave, Suite 106 PERMIT NUMBER: ,;oO Valle SPSpokane Valley, WA 99206 P 1VOKAA uNE . VAS PERMIT FEE: (509)688-0036 FAX: (509)688-0037 Community Development (509)688-0036 MUG F' 2006 Approach Permit Application BY/ ! RMT CENTER PROJECT ADDRESS/ START DATE ANTICIPATED COMPLETION DATE _ Z2 PROJECT DESCRIPTION (Provide site sketch) Residential Driveway Existing Curb & Gutter Culvert Installation Other Conditions Bond/Insurance certification must be on file with the city. Contractor: Name: Address: 17 Z //t/C7`S l/✓ U'� /� City: L Z State: 6/1/v� Zip: 9rrp3� Phone: 92—q - 6 X63 Fax: Contractor Lic NoWILL JCSOS5/►%Exp Date: / —s — City Business Lic. No: A 0 Commercial/Industrial Driveway Rural Road Section Sidewalk Repair/Construction DISCLAIMER Tht 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 Method of Payment: ❑ Cash ❑ Check ❑ Mastercard Bankcard #: Expires: Authorized Signature: REVISED 19/06 Date t�> ❑ VISA VIN#: William Concrete Inc. —�17717829 E. Washington Rd. __L Valleyford, WA 99036 tvd � �}�� C- N��r�(r►�1zrj i it ke (,kD- tC�el11� C -fie AT CUA 1-1,1? tea - le/ /3715 C a6' - - fl::�PPoJC6 I-ook Up a Contractor, Electrician, Plumber or hlevator Protessional License Detail rage i of s Information in Spanish I Topic Index I Contact Info I Search Home Safety Claims ft Insurance Workplace Rights Trades & Licensing Find a Law (RCW) or Rule (WAC) Get a form or publication 4D Help Return to List > Start a New Search > 0 Printer friendly General/Specialty Contractor A business registered as a construction contractor with LFtl to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Verify Workers' Comp Premium Status Name WILLIAMS CONCRETE SERVICE INC Phone No. (509) 928-6863 Address 17829 E WASHINGTON RD Suite/Apt. City State Zip County VALLEYFORD WA 99036 SPOKANE Business Type CORPORATION Parent Company 9 Business Owner Information a Hide All Check for Dept. of Revenue Account UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Previous License Next License Associated License Specialty 1 Specialty 2 601592690 ACTIVE WILLICS055MC I CONSTRUCTION CONTRACTOR 7/3/1995 1/5/2009 WILLIC*121 J7 11 CONCRETE J UNUSED Name Role Effective Date Expiration Date )EVINY, WILLIAM J 01/01/1980 R Bond Information j) lttps://fortress.wa.gov/lni/bbip/Detail.aspx?License=WILLICS055MC 8/21/2008 .00k Up a Contractor, Electrician, Plumber or Lievator rrowNNiouai "%,Lu.. _ -; Insurance Information Insurance Bond Bond Effective Expiration Cancel impaired Amount Received Bond Company Account Effective Expiration Cancel Impaired Bond Received Name Number Date Date Date Date Amount Date 12 TRAVELERS CNP2599317 01/05/200701/05/2009 $500,000.0012/20/2007 4 CAS Et 206711002 01/02/2002 Until $6,000.00 01/04/2002 SURETY CO Cancelled 11 TRAVELERS CNP2599317 01/05/200601/05/2007 $500,000.0012/28/2005 3 CAS Et 206711002 03/21 /2001 01/02/2002 $4,000.00 03/21/2001 10 SURETY CO 52SBAPP1404 01/05/2005 01/05/2006 $500,000.0012/09/2004 9 UNITED 52SBAPP1404 01/05/2004 01/05/2005 $500,000.0012/24/2003 2 PACIFIC 6711002 06/15/1999 Until 03/21/2001 $4,000.00 7 INS CO 52SBAKC5972 01/05/2003 Cancelled $500,000.0012/26/2002 1 SAFECO 5763946 06/15/1995 Until 05/26/1999 $4,000.00 6 INS CO 52SBAKC5972 01/05/2000 Cancelled 12/31/2001 -; Insurance Information Insurance Company Policy Effective Expiration Cancel impaired Amount Received Name Number Date Date Date Date Date CONTINENTAL 12 WESTERN INS CNP2599317 01/05/200701/05/2009 $500,000.0012/20/2007 CO CONTINENTAL 11 WESTERN CNP2599317 01/05/200601/05/2007 $500,000.0012/28/2005 INSURANCE 10 HARTFORD CAS INS CO 52SBAPP1404 01/05/2005 01/05/2006 $500,000.0012/09/2004 9 HARTFORD CAS INS CO 52SBAPP1404 01/05/2004 01/05/2005 $500,000.0012/24/2003 8 HARTFORD CAS INS CO 52SBAKC5972 01/05/200401/05/2005 $500,000.0012/08/2003 7 HARTFORD CAS INS CO 52SBAKC5972 01/05/2003 01/05/2004 $500,000.0012/26/2002 HARTFORD 6 CASUALTY 52SBAKC5972 01/05/2000 01/05/2003 12/31/2001 INS CO 5 JUSFEtG BFS243315 01/05/1999 01/05/2000 4 USFEtG CO BFS94854 01/05/1998 01/05/1999 3 FARMINGTON CAS CO 0025784571 01/05/1997 01/05/1998 2 FARMINGTON 0025233744 01/05/1996 01/05/1997 CAS CO 1 FARMINGTON 0023586495 01/05/1995 01/05/1996 CAS CO https://fortress.wa.gov/lni/bbip/Detall.aspx?License=WILLICS055MC 8/21/2008 Look Up a Contractor, Electrician, Plumber or Elevator Yrotessional License Oetail rage s of s A,ccriss About Lftl I Find a job at L&I I Site Feedback 1 1-800-547-8367 Washington'O © Washington State Dept. of Labor and Industries. Use of this site is subject to the laws of the state of Washington. <e ai wee Crn nt 5+4a s;t, Access Agreement Privacy an ecurityta_t I Intended use/external content.poticy I Staff only link lttps://fortress.wa.gov/lni/bbip/Detal1.aspx?License=WILLICS055MC 8/21/2008 S"pokan� e� Walley Development Engineering 11707 E Sprague Ave Suite 106 ♦ Spokane Valley WA 99206 509.921.1000 ♦ Fax: 509.921.1008 ♦ cityhatt@spokanevalley.org Approach Permit Application Review TO: Building Department Site Address: 13715 E. 26th Project No: 8-3273 Accepted Not Accepted Approach X Building Location Paved Access Notes: Reviewed By:�' i* Date• ��