2001, 02-02 Permit App: 01000625 MHProject Number: 01000625 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/2/01 Page 1 of 2
Project Information:
Permit Use: SINGLE WIDE MOBILE HOME SINCE 1979
Setbacks: Front 15 Left: 41 Right: 10 Rear: 25
Site Information:
Plat Key: 001407 Name: LABERRY MOBILE PARK ADD
Contact: PARKER, LILLIAN/MARTIN PARKER
Address: 18830 E ARBOR CIR
C - S - Z: GREENACRES, WA 99016 -9601
Phone: (509) 000 -0000
Group Name:
Project Name:
Parcel Number: 55173.2508 Block: Lot:
SiteAddress: 18830 E ARBOR CIR
GREENACRES, WA USA 99016
Location:: GRE
Zoning: UR -7
Water District:
Area: 7,150 Sq Ft
Urban Residential -7
Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Department
BUILDING
Hold Reasons:
Permit Conditions:
Review
Site Plan Review
BUILDIN . Plan R vi 'w
ZrAii-mo.w om .711.41/4"
ION.1..46W 0: At _
Permit Conditions:
District: G
Owner: Name: PARKER, LILLIAN
Address: 18830 E ARBOR CIR
GREENACRES, WA 99016 -9601
Hold: ❑
Depth: 0 Right Of Way (ft): 60
Released 'By:
`'By:
Released By:
HEALTHDISTRICT Septic System Review � 2. Released By:
Hold Reasons:
Permit Conditions:
PLANNING
Hold Reasons:
Permit Conditions:
Permits: �'"_rl .a..„
Landuse /Zoning
i7O1 /TlI___ r _
tc-
Released By:""'
Project Number: 01000625 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/2/01 Page 2 of 2
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
INSPECTION FEE
COUNTY SURCHARGE
Payment Summary:
Operator: DMD
Permit Type
Manufactured Home
Notes: :.
Manufactured Home
Firm: OWNER
Phone: (000) 000 -0000
Units Unit Desc Fee Amount
1 SECTIONS $50.00
1 Y OR BLANK $11.00
Printed By: DMD
Permit Total Fees: $61.00
Print Date: 2/2/01
Fee Amount Invoice Amount Amount Paid Amount Owing
$61.00 $61.00 $0.00 $61.00
$61.00 $61.00 $0.00 $61.00
o
1 {
So
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: /
Assessor's Tax Parcel Number(s):
i73- .1 S—r,
Legal Description:
Project Description:
s
r Z.) r 6 /-t /
O Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
O Relocation
O Sign
O Tenant (New /Change)
O Other
OWNER /APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
❑ Owner:
i/ /// Ij/�
Phone:
- � Cc_ ra
❑ Applicant:
Phone:
Fax:
Mailing Address:
//c> /A
I
9'4° A e r
Mailing Address:
Dimensions
\`City, State, Zi
2"d floor sq. ft.
City, State, Zip
Occupancy group
❑ Contractor
Phone
Fax
❑ Architect/Engineer
Phone
Fax
Mailing address
Mailing address
City, State Zip
City, State Zip
WA State Contractor license #
Contact name:
T INFORMATION
Building height to peak
N of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. h.
Deck sq. ft.
Cost of project
Heat source (electric, gas, etc.)
Manufactured Horne
Width:
1
Length:
',Sign
Year:
/9 7i
What is the square footage of the sign
face?
# of signs
How high is the sign?
Area of existing signs
Previous address
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
Proposed use
Value
ecia
nfipection'
Firm Name
Phone
on Resldentia
0111
nC
Plans Examiner
Phone
Inspectors:
Address
Inspector
Phone
O Concrete 0 Welding O Bolting O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes 0 No
Ifyes, identify on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
If yes, identify on site plan 0 Yes D' No
What is the current use of this property?
Is your property in a designated wildlife habitat area?
0 Don't know O Yes 0 No
Will the site be served by a septic system? O Yes O No
Is any part of the property within a 100 yr flood plain?
Ifyes, identify on site plan
O Maybe 0 Don't know O Yes 0 No
Are or will there be wells located on the property?
Ifyes, identify on the site plan O Yes O No
Are there any wetlands, streams or ponds within 200 feet of the
property?
Ifyes, identify on site plan O Yes O No
Is there evidence of fill or excavation on the property?
0 Yes O No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) O Yes 0 No
Are critical or hazardous materials used or stored on site?
0 Yes O No
DEPARTMENT USE 0
Ts the property in a desigaatetI Storinwatcr Control Area?
OYes 0 N
s public sewer available to the site? 0 Yes O No
Is public water available to the site? 0 Yes 0 No
Is the property inside the ASA?
O Ycs
O Yes
0 No
0 No
Is the property inside the PSSA?
0 Ycs
0 No
Is the property- located within 1000 feet of a Natural Resource Area?
0 Yes O No
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ CASH ❑ CHECK ❑ MR= ❑
€WCCVE
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
BANKCARD NUMBER:
EXPIRES:
AUTHORIZED SIGNATURE:
SUBTOTAL
TOTAL, FEE
MINIMUM J'J:R1fIT ELF 1S P+s_CC PLEASE
MAKE (J iu.<KS PAYABLE TO SPOKANE
C�:jPs YITI:Mt'1'CENTER
1CDS
L\11%)