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2000, 01-10 Permit App: 00000174 MH W/BasementP_ of ect Number: 00000174 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 01/10/20 Page 1 of 3 Project Information: Permit Use: DOUBLE WIDE MOBILE W /BASEMENT•FOR- Setbacks: Front 60 Left: 85 Right: 33 Rear: 100 Site Information: Plat Key: 002044 Name: PLAT "A" GREENACRES IRR.DIS Parcel Number: 55073.1340 SiteAddress: 17120 E BALDWIN AVE GREENACRES, WA 99016 Location:: GRE Zoning: SR -1 Water District: Area: 2.00 Acres Suburban Residential 1 Contact: VALERIY, TITOV Address: 4614 N STANDARD C - S - Z SPOKANE, WA 99207 Phone: (509) 484-6229 District: G Owner: Name: VALERIY, TITOV Address: 4614 N STANDARD SPOKANE, WA 99207 Hold: ❑ Width: 265 Depth: 420 Right Of Way (ft): 40 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information: Department BUILDING BUILDING Comments: Comments: Review Site Plan Review Plan Review dito - HEALTHDISTRICT Septic System Review Comments: ENGINEER Approach / Drainage Comments: PLANNING Landuse /Zoning Comments: -€11\ 1 i "1" Permits: .P-7—.0" 0 T /A1 &PC 0 Ate -h• k� C�- 0 i l.+sL f ,. if be t9t. 1 Project Number: 00000174 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 01/10/20 - Page 2 of 3 Contractor: OWNER Address: 0 000000, 00 000000 Building Permit Firm: OWNER Phone: (000) 000 -0000 Building Characteristics Const Category: New Nbr Of Dwellings: 1 Occupant Load: Bldg W x D: 26 x 66 Building Sq Ft: Req Parking: 0 Handicap Parking: Description Grp BASEMENT U R -3 Type Notes VN Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Contractor: OWNER Address: 0 000000, 00 000000 Item Description VENTILATING FANS MINIMUM FEE ADJUSTMENT Contractor: OWNER Address: 0 000000, 00 000000 Item Description INSPECTION FEE 0 Building Height: 8 Stories: 1 1716 Sprinklers: ❑ 0 Critical Materials: ❑ This Application: Total Project: Su Ft Valuation Sq Ft Valuation 1,716 $19,836.96 1,716 $19,836.96 Totals: 1,716 $19,836.96 1,716 $19,836.96 Units Unit Desc Fee Amount 1 Y OR BLANK $288.00 1 Y OR BLANK $4.50 1 Y OR BLANK $63.36 Permit Total Fees: $355.86 Mechanical Permit Firm: OWNER Phone: (000) 000 -0000 Units Unit Desc 1 NUMBER OF 1 Select Permit Total Fees: Manufactured Home Firm: OWNER Phone: (000) 000 -0000 Fee Amount $10.00 $25.00 $35.00 Units Unit Desc 2 SECTIONS Permit Total Fees: Fee Amount $100.00 $100.00 Project Number: 00000174 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 01/10/20 Page 3 of 3 Contractor: OWNER Plumbing Permit Firm: OWNER Address: 0 Phone: (000) 000 -0000 000000, 00 000000 Item Description CLOTHES WASHER MINIMUM FEE ADJUSTMENT Payment Summary: Operator: RMB Permit Type Building Permit Mechanical Permit Manufactured Home Plumbing Permit Notes: Units Unit Desc 1 NUMBER OF 1 Select Printed By: RMB Permit Total Fees: Fee Amount $6.00 $29.00 $35.00 Print Date: 01/10/2000 Fee Amount Invoice Amount Amount Paid Amount Owing $355.86 $355.86 $0.00 $355.86 $35.00 $35.00 $0.00 $35.00 $100.00 $100.00 $0.00 $100.00 $35.00 $35.00 $0.00 $35.00 $525.86 $525.86 $0.00 $525.86 _,q ADDRESS ZONE ROAD WIDTH 40 FRONT_ %L2 FL ANKING COMMENT REVIEWE B This site p'-- is beinc ! mitted for the purpose of obtainiric a GuiI hg pemiit and is a true and correct representation of the proposal. All known property lines/dimensions, curb lines, structures and easements have been identified. Also indicated are wetlands, bodies of water steep slopes or oiher critical areas. Signed: ` /6(le✓c /� / /1--6)(Y 33 F71 2soS_... frk .�o 73- ame r r �y 31 i�a 59