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2010, 11-17 Permit App: 10003816 MHPermit Center Sfiiik .,„e 11703 E Spra t7 1�[lll Spokane Valle valley” (509)688-0036 J w�� w.s.okanev Community Development e Ave, Sutt�etTBccE%VED , WA 992o67,_nni CENTER FAX0-6956g8lOM7T le .or Manufactured Home Permit Application � c/ 7 a/o04 Cti?/ SITE ADDRESS: Project # Warne Submittal OTHER PERMIT NUMBER: PERMIT FEE: V��/ drat/ (moo/ /1 ASSESSORS PARCEL NO: 551 " 3 - �/ LEGAL DESCRIPTION: 'Biiildiii • Ow'riei-: -.,- Name: Vavit5.%f Sot btfi Name: Address: ' V / 7 f ko ( a /c City: .3"--p7JP4e_ (e(f,4Stat7y n u '-r- Zip: Phone: Fax: City: Contact Pei•soo Name: Phone. Y75__G)0 Goiitractor Name: Address: City: State: Zip: Phone: Fax: Contractor Lic No: Exp Date: City Business Lic. No: • Describe the scope of work in detail: vy(J(cVY�q!fric&L t `(J ✓�C�,/_ i���'�% d -fl f�f�'CIG�- deolc//xJt ✓�ictil�v�'t'd Arvfrc MANUFACTURED HOME Width: alt Length: tM✓nu o� / LYear: 7 • Previous Address: 5 /7%✓L' f• C O 1� 2 trot l / l F-!? o /Ca 6/410 r9c 4t Proposed Use: g S(6 c" / Pit Set: /%(j �eptic ewer: Manufacture: 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 b _roc >s •d Signature Method of Payment: ❑ Cash Bankcard #: Authorized Signature: REVISED B23/2005 \Check Date ❑ Mastercard ❑ VISA Expires: VIN#: Project Number: 10003816 Inv: 1 C.)Application Date: 11/17/2010 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SET 1976 24 X 64 COMMODORE MANUFACTURED HOME Contact: SELBY, VANESSA R Address: PO BOX 745 C - S - Z: SPOKANE VALLEY, WA 99016 Setbacks: Front Left: Right: Rear: Phone: (509) 000-0000 Group Name: Project Name: Site Information: Plat Key: Name: Range District: East Parcel Number: 55173.2104 Block: SiteAddress: 18917 E BLOOM CIR Location:: CSV Zoning: MF -1 Water District: 134 Area: 9,020 Sq Nbr of Bldgs: 0 Lot: Owner: Name: SELBY, VANESSA R Address: PO BOX 745 SPOKANE VALLEY, WA 99016 MF MDR District CONSOLIDATED ID #19 Ft Width: 0 Nbr of Dwellings: 0 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Information: Review Septic Sys Review Released By: Originally Released: 11/17/2010 By: LHALSEY Landuse/Zoning/HE Conditions Released By: Originally Released: 11/17/2010 By: tschmidt Permits • , Manufactured Home Contractor: OWNER Firm: OWNER Item Description SETTING PERMIT Operator: jmm Phone: Units Unit Desc 2 # SECTIONS Printed By: jmm Permit Total Fees: (000) 000-0000 Fee Amount $100.00 $100.00 Print Date: 11/17/2010 Project Number: 10003816 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/17/2010 Page 2 of 2 Notes: Same location. 2 bedrooms. Payment Summary Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Manufactured Home $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $100.00 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: jmm Printed By: jmm Print Date: 11/17/2010 Project Number: 10003816 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/17/2010 Page 1 of 2 Project Information: Permit Use: SET 1976 24 X 64 COMMODORE MANUFACTURED HOME Setbacks: Front Site Information: Plat Key: Left: Right: Rear: Contact SELBY, VANESSA R Address: PO BOX 745 C - S - Z: SPOKANE VALLEY, WA 99016 Phone: (509) 000-0000 Group Name: Project Name: Name: Range District: East Parcel Number: 55173.2104 Block: SiteAddress: 18917 E BLOOM CIR Location:: CSV Lot: Owner: Name: SELBY, VANESSA R Address: PO BOX 745 SPOKANE VALLEY, WA 99016 Zoning: MF -1 MF MDR District Water District 134 CONSOLIDATED ID #19 Hold: ❑ Area: 9,020 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: 4 Depth: 0 Right Of Way (ft): 0 Review Septic Sys Review Released By: ' - - - c ineLk- . +c t &LLS.tk coy OILt-ti1 ect-0 Landuse/Zoning/HE Conditions Released By Permits: Manufactured Horne Contractor: OWNER Firm: OWNER Phone: (000) 000-0000 Item Description SETTING PERMIT Units Unit Desc 2 # SECTIONS Operator: jmm Printed By: jmm Fee Amount $100.00 Permit Total Fees: $100.00 Print Date: 11/17/2010 Project Number: 10003816 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/17/2010 Page 2 of 2 Notes: Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Manufactured Home $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $ I00.00 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: jmm Printed By: jmm Print Date: 11/17/2010 Fohn 23 © Copyright 2010 Manufactured Rome Northwest Multiple Listing Service Rev. 07/10 ALL RIGHTS RESERVED Page 1 of 5 MANUFACTURED HOME PURCHASE & SALE AGREEMENT 1 iI,`f 2C-10 t SPECIFIC TERMS 1. Date: 2. Buyer: f'�,'L1-/;(' se-i.ti CI el t't id/i{ / 1 �%3 �i4:,14 - --- MLS No. 3. Seller: j)C-7.111,i f r') Lrl f Gli ft? , ,i- _ _ . . 4. Property: Manufacturer: 6Lc`' r'i'1 vile Ci 6''J,' L` Serial Na.. ANC b dYear: / /t"' Space No.:, Cc,°n LYt di') r to rc_J P Street Address: j/ ' r _C...j,;�5_y Qv.5prfy r,erid�r. Washington Legal Description: Attached as Exhibit Ad 7-0J i.i e_ i1 ,-) ,_,12.4( ..cf. tj,.t v25 ,p xp c'iv�e j j Z 1 la( Real Property Transfer: 0 fee title 0 lease D month to month rental at $ // per month Tax Parcel No(s).: ( County) 5. Included Items: 0 existing expansion and/or add-on; j stove/range; , refrigerator; .washer; ® dryer; [] dishwasher; 0 satellite dish; 0 wood stove; D fireplace insert; O security system; ❑ hot tub; other _ 6. Purchase Price: $ � �;1 &'&) ,4y1 z; k 1-10;11z r� I �`�� ;Jv rr{!U ". Ji S i C-E)iVCr 7. Earnest Money: (To oe held by [] Selling Firm; ® C€osing'Agent) Personal Check: $ ; Note: $ ; Other ( ): $ 8. Default: (check only one) Forfeiture of Earnest Money; [] Seller's Election of Remedies 9. Disclosures in Form 17: Buyer O will; ►,i will not have a remedy for Seller's negligent errors, inaccuracies, or omissions in Form 17 10. Title Insurance Company: 11. Closing Agent: a qualified closing agent of Buyer's choice; 03 12. Closing.Date: one week after signed around 13. Possession Date: 14 on Closing; El Other 14. Offer Expiration Date: Nov. 2010 15. Services of Closing Agent for Payment of Utilities: 0 Requested (attach Form 22K); 13 Waived 16. Charges and Assessments Due After Closing: 1M assumed by Buyer; p prepaid in full by Seller at Closing 17. Buyer Review of Rules/Regulations' Waived; D Contingent on Buyer's disapproval; o days after receipt of mobile home park rules and regulations 18. Lease Contingency: days after mutual acceptance 19. Agency Disclosure: Selling Broker represents: 0 Buyer; j Seller; o both parties; 0 neither party Listing Broker represents: Seller; 0 boh parties 26. Addenda: AJ ?n',�t �l� L•0G� /Yf�r1�l/� °??v�� fF ; lvi� . ! J J �1 • ,iyy>„�% j r '" 1)6- 10 Date . S.. atu - a . ddy & rAlejAfi B er's Signature / ssa g)Q. �l Date Sellers Signature Date Sellers Signature Date Buyers Address City, State, Zip Phone No. Seller's Address City, State, Zip Fax No. Phone No. Fax No. Buyers E-mail Address Selling Firm Sellers E-mail Address MLS Office No. Listing Firm MLS Office No. Selling Film's Assumed Name {if applicable) Listing Firm's Assumed Name (if applicable) Selling Broker (Print) MLS LAG No. listing Broker (Print) MLS LAG No. Phone No. Finn Fax No_ Phone No. Firm Fax No. Selling Brokers E-mail Address Listing Broker's E-mail Address M3Mcadams Realty 911 5 Monroe Spokane, W.\ 99200 Phone: 509.4582727 Fa{: 509.458 2729 Evelyn McAdams Produced with 7:ipForrn19 by ripLogix 18070 Fifteen Milo Road, Fraser, Michigan 48026 ynys 1 Heir 1J baed 411, •'•:7 ...c•tERTFCATENMBER"! • S1 -ATE OF2WASUINGTON I IFICATEOF �WNERSHIflTITL 4•13W11-- •"--„,• • ".•44: r 1•* ..„.. 10fri• •, , ; NUiBER.!,NUMBEW(VIN)... ••••`,..c.' • !YEAR "" •;" ?v/AKE.i'e. .11 11/4400Elf, ;--*, • Sre, k ,•• .4- •:••;:„. • • ' •• •• •••••• • ;‘' . „. ;.• : • "r• AMETERits: ot...;;.•••.Y ••• • •,'„, ••• aclac.IssUtt-15 z, 9 EtEllST.ATUS.':„T:-.'....::• 'tlAt.ltvit..- 04/18q008" .14 7.4" c'EXEMP:rf • • . - • - - ;- ••• • ..a..••••; - • • ' • • G••• %-.:•-• • - .012A8S‘`f.4.1:. -nrWlE. iffe\fEHICLE COLOR Mos, COMMENTS • • ,k• '• • • . ••` BRAN••••1•.••1:1_ ,•;1' -: '' t • ,,,,:,,.., ,,,, • . ;••1•. - -, 1.•• . 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"ap-rE• • - ' . • • . - • fit71msilLT : •" Cif• .1 1.1KEE1RiA.S hr0.1-7AcE; *:. - 5.11,1011W-4441 • ke r.5.0.;;;.e•,..4 • . 1 IA4 yatt are the buyer: pp;.; nevi Ce.-.11-T;ta(eo CA.t.T.sr.5.1-.ip r.;!roin 15 colander eLys of acq,:irirlp tha Th;: the the t.o you. kv•.-81 •ir.,hics cazi; E.Cid pay theSi};::prrJ.a-,-fos. YlitI51 also compiets -zn applicaNI fof Owne:ehip. ;; p.fauff.7:c.. •n• at tyz...te.ild.tr.n.-_-,cm, or Cron; yovr ofigt.s. if you an not trines. -,r re -4 vi,:hin 15 (7,•;Fanciar rlire !s. a panz.hy f. MANUFACTURING PLANT The Commodore Corporat iosi of Oregon 250 1. Hansard Ave Lebanon, Oregon 97355 COMPLIANCE` CERTIFICATE 9-76 Date of Manufacture - 6982 24x64 3f&R2 76-72 Manufacturer's Se < < ber and Model Unit Designation State of Washington Design approval by (D.A.P.I.AL) If questions tions regarding the operation, maintenance, warranty or performance of this mobile home should arise please contact the dealer from whom it was purchased, the manufacturing plant listed below or: Answers to moat questions regarding operation, installation, maintenance and design capabilities are found in the appropriate suctions of the owner's maintenance and information manual and installation instructions furnished with each mobile home. This mobile home is designed to comply with the federal mobile home safety standard in force at the time of manufacture. The factory installed equipment includes: Equipment Manufacturer Wes co For heating For air cabling For cooking G & S Refrigerator Hotpoint Water heater Rheem Modal No. 17.5 R35GH-10 CTA I4CTB 666x'ios Equipment Washer Clothes Dryer Dishwasher Garbage Disposal Other Manufacturer G&S Model No. 5151 STRUCTURAL DESIGN BASIS CERTIFICATE North Middle South Note: Hawaii, Canal Zone, Puerto Mico and Virgin Islands are South Zone seihn North ' R'I DESIGN ROOF LOAD ZONE MAP South 20 PSF Middle 30 PSF -North 40 PSF—.—Other---PSF DESIGN WINDZONE MAP X Standard Wind Zone I 16 PSF Horizontal 9 PSF Uplift Hurricane Resistive Zone!! 25 PSF Horizontal 15 PSF Uplift _PSF Horizontal „PSF Uplift Other HEATING AND CODLING DESIGN BASIS CERTIFICATE r—Tbe above heating equipment has the capacity to maintain an 1 aye rage 70° F temperature in this home at outdoor temperatures of f To maxirnize furnace operating economy, and to conserve energy, it is recommended that this home be Installed wherq the outdoor winter design temperature (977%) b not higher than+ `F. The above information has been calculated assuming a maximum wind velocity of 15 MPH at standard atmospheric pressure. The air distribution system of this home b s iitai+lo for tho In- stallation of central air conditioning. The supply air distribution system installed in this home is size4 for Mobile Home Central, Air Conditioning Systems of up to 3 1)00 0 i3 T U /Hr rated capacity which are certified in ac- cordance scordance with the appropriate Air Conditioning and Refrigeration Institute Standards. When the air circulators of such air Conditioners "s) • RECEIVED CSV PERMIT CENTER NOV t_3 2010 Projw,:t ' PLANNING DEPT. APPRO BY: DATE: oh -OD avt/il c