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Home My WebLink About2001, 06-20 Permit Application: 01004867 MH PlacementProject Number: 01004867 Inv: 1 4 Application Date: 6 /20/2001 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: DOUBLE WIDE MANUFACTURED HOME 1 30 Setbacks: Front Jer Left: 42 Right: 51 Rear: MT' Site Information: ................... ............................... ................... ............................... ................... ............................... ................... ............................... Plat Key: 005254 Name: SP- 744 -92 Contact: BROCK, JEREMIAH Address: 22105 E WELLESLEY #24 C - S - Z: OTIS ORCHARDS, WA 99027 Phone: (509) 927 -7012 Group Name: Project Name: District: F Parcel Number: 45163.0298 Block: SiteAddress: C7 AVE Owner: Name: BROCK, JEREMIAH SPOKANE, WA USA 99206 Address: 22105 E WELLESLEY #24 Location:: SPO OTIS ORCHARDS, WA 99027 Zoning: UR 3.5 Urban Residential 3.5 Water District: Area: 17,811 Sq Ft Width: 111 Depth: 135 Right Of Way (ft): 25 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Lot: B Hold: ❑ Department Review BUILDING Site Plan Review Hold Reasons: Permit Conditions: BUILDING Hold Reasons: Permit Conditions: ENGINEER Hold Reasons: Permit Conditions: Released By: Plar Review Released By:. Approach / Drainage Released By0 1I' UTILITIES Sewer Review of s Reasons: Permit Conditions: Perilitts: 9- 9-0 Released By: cR ,'lam C€J4-> Project Number: 01004867 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 6/20/2001 Page 2 of 2 Manufactured Home Contractor: OWNER Firm: OWNER Address: 0 Phone: (000) 000 -0000 000000,00 000000 Item Description INSPECTION FEE COUNTY SURCHARGE Payment Summary: :;:; Operator: MKC Permit Type Manufactured Home Notes: Units Unit Desc 2 SECTIONS 1 Y OR BLANK Printed By: MKC Fee Amount $100.00 $22.00 Permit Total Fees: $122.00 Print Date: 6/20/2001 Fee Amount Invoice Amount Amount Paid Amount Owing $122.00 $122.00 $0.00 $122.00 $122.00 $122.00 $0.00 $122.00 ilk SPOKANE COUNTY ri / PROJECT APPLICATION WORK SHEET / ` SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509- 477 -3675 SPECIFIC SITE INFORMATION Street Address: /! () ZS— l t Assessor's Tax Parcel Number(s): 15 —, / 3 ().2_ Legal Description: Project Description: .S ' i4" ' / , , P/4, p nowt,, toc7z rre (7A01 4'I� O Building Permit • Change in Use 0 Grading O Manufactured Home Permit O Relocation O Sign 0 Tenant (New /Change) O Other Department Use Only ❑ Applicant i� Phone: / / Fax: Water District /Purveyor: Sewer District /Purveyor Road width Total habitable space PIOs e Setbacks Front Left: Rear Right: School Distri 1I` ` Fire District ❑ Co tractor Phone ((7 ' Ito7-p 1'a` Zoning C OWNER /APPLICANT INFORMATION who should be tontarted re garding this prq"ea ❑ Owner. Phone: 9z7 _ 70 % 2 r �Jetel4.1,a. evoc k Fax: ❑ Applicant i� Phone: / / Fax: Mailing Address: L2 /O 1/17 / /eSky 2 H Unfinished basement sq. ft. Mailing Address: / I Total habitable space PIOs e City, State, Zip 01-7 s O ft kA1�' li/ 2902 % City, State, Zip / r Construction type ❑ Co tractor Phone ((7 ' Ito7-p 1'a` Deck sq. ft. ❑ Architect /Engineer Phone Fax ,5r. Mailing address ! 90 A," 1 � 1 6, / Mailing address Mailing City, State Zip Sp- kiK1 �✓� 99'211/ Zip City, State Zi i \C :A State Con ractor ucnse # Contact name PROTECT INFORMATION Building Information Building height to peak �� # of stories Main floor sq. ft. Unfinished basement sq. ft. Dimensions 20)Y40 Total habitable space PIOs e 2 "d floor sq. ft. Finished basement sq. ft. Occupancy group Construction type Garage sq. ft. Deck sq. ft. Cost of project bleat source (electric, gas, etc.) Manufactured Home Fire Safety Width: 7 N L, Length: 1/0 A4 —at is the square footage of the sign face? How high is the sign? Year: /9 9 9 j Make: �� „CS / # of signs Area of existing signs Fireworks display ; \re critical or hazardous materials used or stored on site? 0 Yes Cpl No Address Proposed use Relocation Fire Safety I irm Name What is the current use of this pro,p �° ty? Veer ri Previous address Will the site be served by a septic system? 0 Yes Il�No Paint booth Fire Sprinkler Tent Fire Alarm Fireworks display ; \re critical or hazardous materials used or stored on site? 0 Yes Cpl No Address Proposed use Value Special Inspections Required? Non- Residential Energy Code Compliance? I irm Name What is the current use of this pro,p �° ty? Veer ri Phone Will the site be served by a septic system? 0 Yes Il�No Plans Examiner Phone Inspectors: Is there evidence of fill or excavation on the property? 0 Yes EKo Are there slopes greater than 30% on the property? (304/4 in 100 ft) ( / %) 0 Yes No ; \re critical or hazardous materials used or stored on site? 0 Yes Cpl No Address 0 No Is the property located within 1000 feet of a Natural Resource Area? OYes 0 N Inspector Phone 0 Concrete O Welding O Bolting O Reinforcement \dares DITIONAL SITE INFORMATION Are there structures on the property? O Yes fi No Ifyes, identify on site plan What is the current property size? (square feet or acres) /r)00 0 Sf , ., ,o 71 Is any part of the property within 250 feet of a shore i e? Ifyer, ident on site plan O Yes No What is the current use of this pro,p �° ty? Veer ri Is your property in a designated wildlife habitat area? 0 Don't know 0 Yes No Will the site be served by a septic system? 0 Yes Il�No Is any part of the property within a 100 yr flood plain? Ifyer, identify on site plan 0 Maybe 0 Don't know 0 Yes No Are or will there be wells located on the property? /yes, identi on the site plan 0 Yes gr<o Are there any wetlands, streams or ponds within 200 et of the property? Ifyer, identify on site plan 0 Yes No Is there evidence of fill or excavation on the property? 0 Yes EKo Are there slopes greater than 30% on the property? (304/4 in 100 ft) ( / %) 0 Yes No ; \re critical or hazardous materials used or stored on site? 0 Yes Cpl No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? 0 Yes 0 No Is public sewer available to the site? 0 Yes 0 No Is the property inside the ASA? 0 Yes 0 Yes 0 No 0 No Is public water available to the site? 0 Yes 0 No Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? OYes 0 N Date Received: Staff Representative: METHOD OF PAYMENT V/SA ❑ CASH ❑ CHECK ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DAZE: BANKCARD NUMBER: EXPIRES: AU'1'HORI'ZE1) SIGNA'T'URE ?: SUBTOT;V . TOTAL FEE MINIMUM PERMIT FEE IS $35.00 PLEASE MAKE CHECKS PAYABLE TO SPOKANE COUNTY PERMIT CENTER t I 1 I • t 414 4 it --- . , ' I e 1 1 , 44 . . : 1 I • 1 I I I t I { ■ ■ i -± 1 i I I i I 1 1 i 1 . „......_.„..,_ ;• 1 i 1 I i I ! ! i ! I i Id I I i . 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