2004, 06-01 Permit App: BLD-04-04475 MHSpode
.0,.0Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
MANUFACTURED HOME
Job Address: 18301 E ALKI AVE
GREENACRES WA 99016
Description: TRIPLE WIDE MANUFACTURED HOME
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
ORR, EDWIN R
ORR, EDWIN R
702 N GREENACRES RD
GREENACRES, WA 99016
General Information:
SECTIONS
YEAR BUILT
DIMENSIONS
# OF STORIES
# OF BEDROOMS
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
FLANKING SETBACK
MANUFACTURER
Lot: Blk:
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Application #: BLD -04 -04475
Applied:
Issued:
Expires:
Parcel No. 55184.1011
N\,,, Phone: (509) 924 -4 3
3w
4004/
40 52
2
35
45
25
53
25
HO E BOYS
REVIEWED FOR C
8 ILDINGS:
P one:
L' No:
Fees:
PER SE
Zoning:
06/01/2004
11/28/2004
Total C ted:
Depos Re fpts:
150.00
150.00
0.
151.00
EN
1NEERS:
FIRE DIS
ICT: DATE:
DATE:
THIS IS NOT A RECEIPT
•••"%i,
Spo'kane
.0001/alley
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688 -0036; Fax: (509) 688 -0037
REQUIRED SITE INFORMATION
Si go c �9oi6-
Street Address: / D 3o � A / A i' vM ' xsxy�h�iL_
Assessor's Tax Parcel Number(s): 5-57 g 27, / 01/
Gorh�/1 Add G ,>acm / 8 /0e" 42
Legal Description: S 026-'/.Lo t 9 ,'26e. /0 f7cc' E 3D ' f7 i�aw d✓
PERMIT DESCRIPTION:
Building Permit
❑ Relocation
❑ Change in Use ❑ Grading M Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
®, Owner: /� ri v ;, ,e 4/toe
Phone: 9a /- y5,2 3 Fax:
Address: 7 of /eV
/ //f /-/a .
State Zip Code
ity
❑ Contractor:
Phone: Fax:
Address:
City
State Zip Code
WA State Contractor License #:
Applicant:
Phone: Fax:
Address:
City
State Zip Code
❑ Architect:
Phone: Fax:
Address:
City
Contact:
State
Zip Code
PERMIT /BUILDING .INFORMATION
HEIGHT TO PEAK:
/y f=W./-
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"" FLOOR SQ. FTG:
UNPIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON -SITE SEPTIC
SYSTEM?
MANUFACTURED HOME
Width: ///'' Length: ��
9 Year: �l'l -) Pit Set: yes
Manufacturer: 1-1 61 �
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above /Underground Storage Tank Size:
WASHINGTON STATE NON- RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Inspector:
Address:
Phone:
Fax:
City
Phone:
State
Fax:
Zip
City
State Zip
SPECIAL INSPECTIONS
I-1 BOLTING n CONCRETE
Firm Name:
REINFORCEMENT P1 WELDING
Phone:
Inspector(s):
Fax:
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature 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.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN #:
Authorized Signature:
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