2010, 05-07 Permit App: 10001261 MHSr,ti �,� Permit Center _
pokane 11707 E Spragae7i^(re;"5uiie 10t tV'E 0
Spokane Valley, WA 99206
�,I/'�Va1ley ( 09)688 -0036 FAAQ� X09)688 -803' ENTER
Community Development www.spokan,valley.org MO
Manufactured Home 6,o; t#
Permit Application
PERMIT NUMB'
PERMIT FEE:
Z (o(
SITE ADDRESS: 0.3o, E. Ati,til e,
ASSESSORS PARCEL NO: 5 <j 633,'/ J LEGAL DESCRIPTION
Building Owner:
- --.I
Name: /r`i S S1ON Ui, „ 5 LL
f /E
Name: 064)401..
a2.
Address: / 5 v e comerz»i
City: kilhe / Q / e State: wit
J
Zip:g9o37
Phone: Fax: 5 v y ys 3.Z 3
City:
Contact Person
Name:
Phone: 50?. -153 -3Y L3
Describe the scope of work in detail:
Contractor:
- --.I
••••• .• • li /
Name: 064)401..
Address:
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No:
Exp Date:
City Business Lic. No:
sd 4 eiA) iAaJcifried 4rfrbe-
MANUFACTURED HOME
Width: 30 — v
Length: 5-2.../.0
Year: Z 001
Manufacture: /4 3/014
Previous Address: /1) /4
Proposed Use: 4 eS iqc",
Pit Set: yes
S 4 ewer:
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 can be processed.
Signature
Method of Payment_
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 8/23/2005
7447-r7k
❑ Check
❑ Mastercard
Expires:
Date
❑ VISA
VIN #:
10/0
Project Number: 10001261 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SET 2009 30 X 52 CLAYTON MANUFACTURED Contact: MISSION MEADOWS LLC
HOME Address: 15918 E CAMERON CT
C - S - Z: SPOKANE VALLEY, WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 953 -3923
Group Name:
Site Information: Project Name:
Plat Key: Name: Range
Parcel Number: 55083.9601 Block: Lot: 78
SiteAddress: 19301 E BALDWIN LN Owner: Name: MISSION MEADOWS LLC
Address: 15918 E CAMERON CT
Location:: CSV SPOKANE VALLEY, WA 99037
Zoning: R -4 SF Res Urban District
Water District: 134 CONSOLIDATED ID #19 Hold: [J
Area: 0 Sq Ft Width: 53 Depth: 85 Right Of Way (ft): 35
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Date: 5/7/2010 Page 1 of 2
District: East
Review Information: powswolmomprgootruwmmummacommmtotmmgamplommojm
Review
Landuse /Zoning/HE Conditions
Permits:
Released By:
Contractor: OWNER
Item Description
SETTING PERMIT
Originally Released: 5/7/2010 By: mharnois
Manufactured Home
Firm: OWNER
Phone: (000) 000 -0000
Units Unit Desc
2 # SECTIONS
Operator: jmm Printed By: jmm
Fee Amount
$100.00
Permit Total Fees: $100.00
Print Date: 5/7/2010
Project Number: 10001261 Inv: 1
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/7/2010
Payment Summary:
Permit Type
Manufactured Home
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.
Fee Amount
$100.00
$100.00
Invoice Amount
$100.00
$100.00
Amount Paid
$0.00
$0.00
Amount Owing
$100.00
$100.00
Page 2 of 2
Signature:
Operator: jmm Printed By: jmm
Print Date: 5/7/2010
BALDWIN LANE
z
a
LOT 36
19301 E. Baldwin Lane
Prepared for: Clayton Homes
North
Scale: 1" = 20'
Home Manufacturer:_ Clayton Homes
Width: 30' 0" Length: 52' 0"
Resident approval of site plan
Signature
224 date 4/77/
Signature
date
85.95°
/017L- 20'
3
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