2009, 05-22 Permit App: 09001826 Approach Sc�mti• �" ter„ Permit Center RECEIVED BY f
ikane PERMIT NUMBER:9- I gT
11703 E Sprague Ave, Suite 1>1rRiY O F�i'C;at q NIDE
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Community Development (509)688-0036 FAX:(509)688-0037 .. 'F_4
www.spokanevalley.org
PE IIT CENTER
Approach Permit Application v
PROJECT ADDRESS 1/ 31Y 3/0 M4
START DA 1'h S—Z 2`0 ANTICIPA 1'ED COMPT.FTION DA 1'h 5 -Z✓F' U
Building Owner: Contractor: 1-0 dir r„,,,,,,.4,... (
Name: t2OI)/Je. r J-ea t _ i/v1-4►2f-►r/ Name:
Address: J i ?j i G e -3 ,1 6Address: 1 g(/' 7 C 4 LK
City: .,rkSie#.o.IJa)loi Stater Zip:qq7(), City: 9- J'4 kle� State:,�JA. Zip:q9 two
Phone: Fax: Phone:
9 qzi5,--533 Fax: 'g. (3v(...`{ L
Contact Person
Contractor Lic No:A(3o TE ce,q§1s-I e: 6r_A)
Name:
City Business Lic.No: L_v 7 0-2_ ' O s
Phone:
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway Commercial/Industrial Driveway
Existing Curb&Gutter Rural Road Section
Culvert Installation Sidewalk Repair/Construction
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Other Conditions 4 i+ - Die ' A/2`•. 1 ie.c 0 5 f)
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Bond/Insurance certification must be on file with the city.
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 lis / Date —ZZ—U 9
Method of Payment
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard#: Expires: VIN#:
Authorized Signature:
Effective October 28,2007
P:\Community Development\Forms\Building forms\Approach Permit eff 10-28-07.doc
Stthhhuhhhhnh Development Engineering
`alley
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: 11319 E. 36th
Project No: 9-1826
Accepted Not Accepted
Approach X
Building Location
Paved Access
Notes: Saw cutting of existing curb is not allowed within the City's
jurisdiction. Driveway is to be inspected by the City's ROW Inspector prior
to concrete placement.
Reviewed By: iiG% Ae �/, j � Date: � Z� �
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