2013, 08-06 Permit App APR-2013-0042 Approach 06 13 01:18p steve telchlin
Community Development Department (Staff Use Only)
Permit Center
Sti^''A�� 11703 East Sprague Avenue.Suite B-3 PERMIT NUMBER:�P4•24(3'OD Z
Spokane Valley,R'A99206 PERMIT FEE: if 52.00
Valley Tel:(509)720-5240
Fax: (509)688-0037
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APPROACH PERMIT APPLICATION
PROJECT ADDRESS:4229 S DRIFTWOOD SPOKANE VALLEY WA
START DATE: 7/30/13 ANTICIPATED COMPLETION DATE:7/30/13
BUILDING OWNER NAM E:MARY BERKOFF
MAILING ADDRESS:4229 S.DRIFTWOOD
CIIY: SPOKANE VALLEY STATE:WA ZIP:
CONTACT PERSON NAME:MARY
PHONE:922-2894 FAX: CELL:
CONTRACTOR NAME:DUNDEE CONCRETE AND LANDSCAPING
MAILING ADDRESS: 12812 N.CHRONICLE
CITY:MEAD STATE: WA ZIP:99021
PHONE: 509 216 3331 FAX: ? 7 7- Q (/ / 7 CELL:
CONTRACTOR LICENSE#: DUNDECL88SDL EXPIRES:3114 CITY BUSINESS LICENSE
##:
PROJECT DESCRIPTION(Please Provide Site Sketch)
.91 Residential Driveway ❑ Commercial/Industrial Driveway
El Existing Curb&Gutter ❑ Rural Road Section
❑ Culvert Installation ❑ Sidewalk Repair/Construction
❑ Other Conditions:
Bond/Insurance certification must be on file with the City.
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.
SignatureST—I-- Date: OA-Z)
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