2005, 12-03 Permit App: 05004576 MH�x
p
Permit Center .
o�al� 11707 E Sprague Ave, Suite 106
�,,.•'� Valle Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
Community Development www'.spokanevalley.org.co 2Manufactured Home L5 Permit Application
AaTECMW
SITE ADDRESS
ASSESSORS PARCEL NO: 5f 143 . 2 C S LEGAL DESCRIPTION:
Building owner .?
Name:
(Lliv,c1
Address: _, '2-6C A
City: t► JrsrsF
Zip :� GS
phone:jcS/-7S-Edl.
:,S
Contact Perso
Name:
Phone: 7 !S 0d FAc
Describe the scope of work in detail:
Contractor
Name: ( D f) 1C'L rdzsl -
Address: , 2 / F c'/ GQ&V C /
City: (.1, tJ Zip: S -73.Y /5
Phone:
7_S Fax:
Lic No:
Exp. Date:
City Business Lic No: ,- -"
87
MANUFACTURED HOME
Width:
Manufacture: v"ZIU ry
Pad I' r'
Previous Address: L' I'�a I �J . v , ;0/ / t, Add . ro4celtir-
Proposed Use: ' BSc a —(L
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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application be pr es
Signature 1))/"� -- Date
Length: 5c,
Year:
Pit Set:
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN #:
❑ Other
Authorized Signature:
REVISED 8/23/2005
f970_ C471/4../_4_,
--4 a
ig
91.5 1
Project Number: 05004576 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/06/2005 Page 1 of 2
Project Information:
Permit Use: MANUFACTURED HOME SET
Contact: TED MCCAFFREE
Address: 2881 RED CEDAR CT
C - S - Z: COEUR D'ALENE ID 83815
Setbacks: Front 27 Left: Right: 11 Rear: 30 Phone: (208) 644 -8756
Group Name:
Site Information: Project Name:
Plat Key: Name: RANGE
District: East
Parcel Number: 55173.2505 Block:
SiteAddress: 18818 E ARBOR CIR
Location:: CSV
Lot:
Owner: Name: HOWLAND SPECIAL NEEDS TRU
Address: 1201 W PLACITA QUIETA
GREEN VALLEY, AZ 85614
Zoning: UR -7 Urban Residential -7
Water District: Hold: ❑
Area: 10,000 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Site Plan Review
Released By:
Plan Review
Originally Released: 12/05/2005 By: cjjanssen
Released By:
N/A -PER MANUFACTURES SPECS
Originally Released: 12/05/2005 By: cjjanssen
Septic System Review
Permits:
Released; By:
PER LANCE @ COUNTY HEALTH
Originally Released: 12/06/2005 By: cjjanssen
Operator: CJJ Printed By: CJJ Print Date: 12/06/2005
Project Number: 05004576 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/06/2005
Contractor: OWNER
Item Description
INSPECTION FEE
Notes:
Payment Summary:
Permit Type
Manufactured Home
Manufactured Home
Firm: OWNER
Phone: (000) 000 -0000
Units Unit Desc
1 SECTIONS
Permit Total Fees:
Fee Amount Invoice Amount
$50.00 $50.00
Page 2 of 2
Fee Amount
$50.00
Amount Paid
$0.00
$50.00
Amount Owing
$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: CJJ Printed By: CJJ
Print Date: 12/06/2005
12/05/2005 16:04 5093241567
DEC 05 2005 15:49 FR
Project NIkmber: 05004576 Inv: 1
SRHD EHS PAGE 01
TO 324156? P.01/02
Applicati on Date: 12/05/2005
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Page 1 of 2
role& ]:,ftfornlation;
Permit Use: MANUFACTURED HOME SET Conract: TED MCCAFFREE
Address: 2881 RED CEDAR CT
C - S - Z: COEUR D'ALENE ID 83815
Setbacks: Front 27 Left: Right: 11 Rear: 30 Phone: (208) 6.14-8756
Group Name:
Project Name:
$11e Information;
aietwomorwrAlwillownwiwnwrionum.rwAntrraurmsnourrimanomilMIPMNIIIIIMIMIRIMIVEIMARTIAMMIIIIIMAIMPIZI
Plat Key; Name: RANGE District: East
Parcel Number: 55173.2505 Block: Lot:
SiteAddress: 18818 E ARBOR CM O'er: Name: El OWLAND SPECIAL NEEDS TRU
Address; 1201 W PLACITA QU1ETA
GREEN VALLEY, AZ 85614
Location:: CSV
Zoning: UR-7 Urban Residential-7
Water District:
Area: 10,000 Sq 1rt Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
r6iVieW InPriftgriOn: nomminNOM111171111•110.11.41.11111ill=
Hold:
Depth: 0 Right Of Way (ft): 0
Reviw
Site Plan Review
Plan. Review
1•6•B MEOW..
Originally Released: 12/05/200 5, By: cjjantisan
OHM
It440,4%1
• ,•••4 ; a ..4:01:1 4
••v•
•
N/A-PER MANUTACTURES SPECS
Originally Released:
Septic System Review
.Penn its:
12/05/2005 By: cjjanssen
FAXED TO LANCE 12/5/05
Operator: CJJ Prime a By: C.13 Print Dem 12/05/200.3
DEC 05 2005 16:1
5093241567 PRGE . 01
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