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2001, 07-09 Permit App: 01005489 MHProject Number: 01005489 Inv: 1 Application Date: 7/9/01 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: DOUBLE WIDE MOBILE HOME Setbacks: Front 48 Left: 26 Right: 20 Rear: 13 Site Information: Plat Key: MH002 Name: LA BERRY MOBILE PARK Parcel Number: 55173.2509 Block: SiteAddress: 18904 E BLOOM CIR GREENACRES, WA USA 99016 Location:: GRE Zoning: UR -7 Water District: 999 Contact: LAMPLIGHTER HOMES Address: 2201 N CRAIG RD C - S - Z: AIRWAY HEIGHTS WA 99019 Phone: (509) 922-1902 Group Name: Project Name: District: G Lot: Owner: Name: GOODNIGHT, DAVID Address: 18904 E BLOOM CIR GREENACRES, WA 99016 Urban Residential -7 UNKNOWN Hold: ❑ Depth: 0 Right Of Way (ft): 0 Area: 7,150 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Department BUILDING Hold Reasons: Permit Conditions: BUILDING Hold Reasons: Permit Conditions: HEALTHDISTRICT Hold Reasons: Permit Conditions: Permits: Review Site Plan Review Plan Review Septic System Review Page 1 of 2 Released By: ,-,��t��I .k— Released By: C� � Released By: best/ sysiciw cLuig ned bedrooms anty. Manufactured Home Contractor: UNKNOWN Firm: UNKNOWN Address: UNKNOWN Phone: (000) 000-0000 UNKNOWN, WA UNKNOWN Item Description INSPECTION FEE COUNTY SURCHARGE Units Unit Desc 2 SECTIONS 1 Y OR BLANK Permit Total Fees: Fee Amount $100.00 $22.00 $122.00 Project Number: 01005489 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/9/01 Page 2 of 2 Payment Summary: Operator: CKF Permit Type Manufactured Home Notes: Printed By: CKF Print Date: 7/9/01 Fee Amount Invoice Amount $122.00 $122.00 $122.00 $122.00 Amount Paid $0.00 $0.00 Amount Owing $122.00 $122.00 7 ill SPOKAE COINfY 4 PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEi11ENI' 1026 WEST BROADWAY AVENUE SPOKANE, \VA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: ilSfv© y Assessor's Tax Parcel Number(s): 55 17 S� t` i/k 1 99©/l0 Legal Description: Project Description: ��(i(,%' I2Zg7Ju � 7r Jts) hie_e_ ❑ Building Permit ❑ Change in Use ❑ Grading �Alanufactured home Permit ❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other Department Use Only Water District/Purveyor: Sewer District/Purveyor Road width Setbacks Front Rear. Left: Right: School District: Fire District: Zoning OWNER/APPLICANT INFORMATION © lin/r.0/rn•/v,dins/Gr,rnlut/rarr•arrrlirr,J,r; rr4,t PRO Building Information l hirer. Phone: 507-639/'"5-347/ I I .t. 1 b iw 6.1 -l -T 11,Pheant•., LIMP/AG Phone: 6 V7 L7a+Z T 7 ,:a, � S 509 —942.2-19ati N i titling Address: g /V) 6Lf . F1�.'e1� lei j iMailing11Jdress: i !Q`7oi E, ,e Ci 60 t `y (rv, State, /q, C '-E�iv s 604 99z)110 1at,, State, lap C- ° SAI -�S, / 0-)A ?9O / c, Pa 71\rchnet t I :t\g�ncer Phone Fax flailing address P10t80X /30 t�lathnt; addre e (.a\, Sratc tip aL 8380 Cit,, Gate /.ip \\-.\ :;rate Contractor license COR.t NS et 51g e, PANi-rAi n rt 0 Lig K8 (;,,road mune. PRO Building Information Building height to peak # of stones f\ lam floor sq. ft. Unfinished basement sq. 0. Dimensu> r: 1'z>ral habit.tl>le space 2'ffl Boor sq. ft. l hushed basement sq. ft. Oceupancr group Construction type Garage sq. 0. Deck sq. 0. Cuss of proicct I leat source (electric, gas, etc.) Manufactured Home Fire Safety Sign Width: I I t 9,6S- v Length: 6 What is the square footage of the sign face? I Iow high is the sign? Year: Fireworks display Make: Address # of signs Area of existing signs Inspector Phone O Concrete Relocation Fire Safety Firm Name What is the current use of this property? Previous address Will the site be served by a septic system? 0 Yes 0 No Paint booth Fire Sprinkler Tent Fire Alarm Fireworks display Are critical or hazardous materials used or stored on site? 0 Yes O No Address Proposed use Value Special Inspections Required? Non -Residential Energy Code Compliance? Firm Name What is the current use of this property? Phone Will the site be served by a septic system? 0 Yes 0 No Plans Examiner Phone Inspectors- Is there evidence of fill or excavation on the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) (/ %) 0 Yes 0 No Are critical or hazardous materials used or stored on site? 0 Yes O No Address 0 No Is the property located within 1000 feet of a Natural Resource Area? DYes 0 N Inspector Phone O Concrete 0 Welding O Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? 0 Yes 0 No Ifyes, ident01 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? Ifyes, identii on .site plan O Yes O No What is the current use of this property? Is your property in a designated wildlife habitat area? 0 Don't know 0 Yes 0 No Will the site be served by a septic system? 0 Yes 0 No Is any part of the property within a 100 yr flood plain? Ifyes, identifil on site plan 0 Maybe 0 Don't know 0 Yes 0 No Are or will there be wells located on the property? Ifyes, yes, identifi on the site plan 0 Yes 0 No Are there any wetlands, streams or ponds within 200 feet of the property? Ifyes, ident on site plat 0 Yes 0 No Is there evidence of fill or excavation on the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) (/ %) 0 Yes 0 No Are critical or hazardous materials used or stored on site? 0 Yes O No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? DYes 0 N Is public sewer available to the site? 0 Yes 0 No Is the property inside the ASA? 0 Yes DYes 0 No 0 N Is public water available to the site? 0 Yes 0 No Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? DYes 0 N Date Recon cd' Staff Representatoe METHOD OF PAYMENT VISA ❑ c:.\SI1 ❑ CIII':CK ❑ ❑ 0 FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD aril I':SPIRI:S: B.\NKC.\RI) NI \IBI:R: \U1 I I0R1'/.I':1) SUBTOT \1. TOTAL FEE MINIMUM PERMIT FEE IS $35.00P1.EASE MAKE CI IECKS P 1Y \BLE. TO SPOKANE COUNTY PER\til' CENTER Atititit56 I BLOO ZONE LA.. ROAD WIDTH 50 FRONT_9 0 FLANKING cOMMENIS_ R E VIEWED BY G4A-e--64-rou 7 " 1-2.e,r. • .r.d:t-5=ter,