2009, 05-29 Permit App 09001538 ApproachPermit Center
'crryOF TA„� 11703 E Sprague Ave, Suite B-3
r�Li Spokane Valley, WA 99206
o www. pokan 6 FAX: (509)688-0037
4;00www sookanevallev.ore
Community Development
Approach Permit Application
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PERMIT NUMBER: 1
PERMIT FEE:
PROJECT ADDRESS LI `O 's. W ✓\. c �LT
START DATE Cotes \1 c4, g,e{ C ATED COMPLETION DATE
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Building Owner:
-
[factor:
Name:< - t
Name:
Address:
Address:
City;Unfikil
State: Zi : Q
City:
State: Zip:
Phone: q
10011 $' • 9 ry s
Phone:
Fax:
Contact Person
Contractor I.ic No:
Exp Date:
Name: O f
City Business Lic. No:
Phone:
ZZ
PROJECT DESCRIPTION (Provide site sketch)
} V Residential Driveway ? El Commercial/Industrial Driveway
<F-1 Existing Curb & Gutter F Rural Road Section
ElCulvert Installation El Sidewalk R�Repair/ConstructionC,o-nstruction
n Other Conditions W �- W ak l� 4ay-r—
G
Bond/Insurance ceitification must be on file with the
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
Signaturt
Method of
❑ Cash
Bankcard 1..
Authorized Signature:
REVISED 3
Date � ' � t D /
VISA
VIN#:
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Project Number: 09001538 Inv: I Application Date: 5/29/2009 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Permit Use: RES APPROACH Contact: KARNITZ, JOSHUA M
Address: 4108 S CONIFER
C - S - Z: SPOKANE, WA 99206
Setbacks: Front Left: Right: Rear: Phone: (509) 926-1395
Group Name:
Site Information: Project Name:
Plat Key: 004124 Name: PONDEROSA 04TH ADD REPLAT BI L2,3,10,11 (FEES) District: Sout
Parcel Number: 45324.0121 Block: Lot:
SiteAddress: 4108 S CONIFER CT Owner: Name: KARNITZ, JOSHUA Al
Address: 4108 S CONIFER
Location:: CSV SPOKANE, WA 99206
Zoning: R-3 SF Res District
Water District:
Area: 18,930 Sq Ft Width: 100
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review
Driveway/Approach
Permits:
crs'TL'Z�'7Ts�aIS'/U 517
Item Description
APPROACH -CONST IN ROW
Hold: O
Depth: 189 Right Of Way (ft): 0
Released By:
Firm: OWNER
Phone: (000) 000=0000
Units Unit Desc Fee Amount
1 NUMBER OF $50.00
Operator: JD Printed By: JD
Permit Total Fees: $50.00
Print Date: 5/29/2009
Project Number: 09001538 Inv: 1 Application Date: 5/29/2009 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
Permit Tvoe Fee Amount Invoice Amount Amount Paid Amount Owine
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: JD Printed By: JD Print Date: 5/29/2009