2008, 10-03 Permit App 08003924 ApproachN
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Project Number: 08003924 Inv: I
Application
'PHIS IS NOT A PERMIT
Penalties will be assessed fox- commencing work without a permit
Project Information:
Permit Use: RESIDENTLAL APPROACH Contact: FIVE STAR CONCRETE INC
Address: 6225 N MALVERN RD
C - S - Z: OTIS ORCHARDS WA 99027
Phone: (509) 226-1189
Group Name:
Site Information: Project Name:
Plat Key. 001836 Name: OPPORTUNITY TR # 01-354 District: Nort
Setbacks: Front Left: Right Rear:
Date: 10/3/2008 Page 1 of 2
Parcel Number. 45083.0493 Block:
SiteAddress: 9605 E MISSION AVE
Location:: CSV
Zoning: UR-3.5 Urban Residential 3.5
Water District
Area: 72,915 Sq Ft Width: 111
Nbr of Bldgs: 3 Nbr of Dwellings: 1
Review Information: ,.,,._......
Lot:
Owner. Name: ZIER, KELLY G
Address: 19122 E INDIANA AVE
GREENACRES, WA 99016
Hold: ❑
Depth: 640 Right Of Way (ft): 60
Review
Driveway/Approach
Released By
Permits: 1—
Contactor FIVE STAR CONCRETE INC
Address: 6225 N MALVERN RD
OTIS ORCHARDS WA 99027
Item Description
APPROACH-CONST IN ROW
Units
1
Operator. JD Printed By: JD
Approach
Firm: FIVE STAR CONCRETE INC
Phone: (509) 226-1189
Unit Desc
NUMBER OF
Fee Amount
$50.00
Permit Total Fees: $50.00
Print Date:
10/3/2008
Project Number. 08003924 Inv I
Application Date: 10/3/2008 Page 2 of 2
!'HIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
PaymentSummarp:
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. JD Printed By. JD Print Date: 10/3/2008