2002, 09-19 Permit App: 02008114 Relocate MHProject Number: 02008114 Inv: 1
•
,Appl'ication
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 9/19/02 Page 1 of 2
Project Information:
Permit Use: RELOCATE DOUBLE WIDE MANUFACTURED
HOME
Contact: BARCLAY, PATRICK
Address: 892 N KNIGHTS LN
C - S - Z: POST FALLS ID 83854
Setbacks: Front Left: 10 Right: Rear: Phone: (509) 362-2292
5 Group Name:
Project Name:
Site Information:
Plat Key: 006284 Name: SP -1308-02
Parcel Number: 45181.0318 Block: Lot: A
SiteAddress: 8815 E BOONE AVE
SPOKANE, WA USA 99206
Location:: SPO
Zoning: UR -3.5 Urban Residential 3.5
Water District: 005 HUTCHINSON
Area: 0 Sq Ft Width: 69 Depth: 155 Right Of Way (ft): 40
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Owner: Name: BARCLAY, PATRICK
Address: 892 N KNIGHTS LN
POST FALLS ID 83854
Hold: ❑
District: F
Review Information:
Review
Site Plan Review
Plan Review
Approach / Drainage
Landuse/Zoning
Released By:
Release
Released By:
Released By: b
- - - OD_
et/i I
Subdivision/ P
Operator: JAS
Printed By: JAS
Print Date:
Project Number: 02008114 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Sewer Review/ /U,,,�j..4„) _
Date: 9/19/02 five 2 of 2
Permits:
Contractor: OWNER
(t)'.. -71 e7�
Item Description
INSPECTION FEE
COUNTY SURCHARGE
Notes:
Payment Summary:
Permit Type
Manufactured Horne
Released By:
Manufactured Home
Firm: OWNER
Phone:
Units Unit Desc
2 SECTIONS
1 Y OR BLANK
Permit Total Fees:
Fee Amount Invoice Amount
$122.00 $122.00
$122.00 $122.00
Fee Amount
$100.00
$22.00
$122.00
Amount Paid
$0.00
$0.00
Amount Owing
$122.00
$122.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JAS Printed By: JAS
Print Date: 9/19/02
I
„A,
SPOKE COUNTY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 \VEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: O l L /f j5 coy?
e
Assessor's Tax Parcel Number(s): . /► 31
Legal Description:
Project Description: !, /'r l rP p for Am.
El Building Permit
❑ Change in Use
❑ Grading
Ri Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
El Other
Department Use Only
Phone- ? 6 Z -.21 i Z
las
CI Applicant
PhoPhone.r
las:
\Tailing Addrei
/ kZ /lit "iii94/$ it)
I)tmensuins
\Cater District/Pun•eyor:
Sewer District/Purveyor
(.rte, `tate, tip
Occupancy group
Road width
Garage s2{. ft.
❑ Contractor
Setbacks
Front:
Left:
Rear.
Right
School District
lire District. a1
l
Zoning
r �
3
5
enc, State rip
OWNER/APPLICANT INFORMATION
bu/<ide u ho should be , 011!211!211 /i 20rdnrn !hi hrona7
CI (,., ner p /r i G �'` N ear pV h"
Phone- ? 6 Z -.21 i Z
las
CI Applicant
PhoPhone.r
las:
\Tailing Addrei
/ kZ /lit "iii94/$ it)
I)tmensuins
Nailing Address:
2"d floor sc. tt.
(.rte, `tate, tip
Occupancy group
Ott', State, '/.tp
Garage s2{. ft.
❑ Contractor
Phone
las
❑Phone
Architect 1{n},anccr
Tax
\!ailing address
I\Iathng addrex4
Circ, State rip
enc, State rip
\i .\ State Contractor license #
Contact name
PROTECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
I)tmensuins
Total habitable space
2"d floor sc. tt.
Finished basement sq. ft.
Occupancy group
Constriction hype
Garage s2{. ft.
Deck sc. ft.
Cost otproject
I Teat source (electric, gas, etc.)
Manufactured Home
Sign
Width:
' 17
J
Length: _
5 Z
\Xihat is the square Giotage of the sign
face? _
1 low high is the sign? .' - 1
year:
? GIGO'
make:#
Serirrtl'eah 44ieipfl10/1
of sighs
Arca of existing signs
'Tent
Fire Alarm
I ;reworks display
Are critical or hazardous materials used or stored on site?
0 Yes f$) No
Relocation
Fire Safety
I trm Name
What is the current use of this property?
1/ Q C Qi
Previous address
Will the site be served by a septic system? O Yes 3 No
Paint booth
Fire Sprinkler
'Tent
Fire Alarm
I ;reworks display
Are critical or hazardous materials used or stored on site?
0 Yes f$) No
Address
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
I trm Name
What is the current use of this property?
1/ Q C Qi
Phone
Will the site be served by a septic system? O Yes 3 No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
O Yes 04 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / °yo 0 Yes I No
Are critical or hazardous materials used or stored on site?
0 Yes f$) No
Address
Inspector
Phone
0 Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes 17 No
Des, identify on site plan
Z
What is the current property size? i/ AC fi 7T
(square feet or acres) I
Is any part of the property within 250 feet of a shoreline?
Ifjes, identO, on site plan O Yes cyi No
What is the current use of this property?
1/ Q C Qi
Is your property in a designated wildlife habitat area?
0 Don't know O Yes IV No
Will the site be served by a septic system? O Yes 3 No
Is any part of the property within a 100 yr flood plain?
Ifes, identify on site plan
O Maybe O Don't know O Yes CO No
Are or will there be wells located on the property?
"[yes, identif on the site plan O Yes 71 No
Are there any wetlands, streams or ponds within 200 feet of the property?
If yes, identif, 0n site plan O Yes No
Is there evidence of fill or excavation on the property?
O Yes 04 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / °yo 0 Yes I No
Are critical or hazardous materials used or stored on site?
0 Yes f$) No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
0 Yes
O No
Is public sewer available to the site? O Yes O No
Is the property inside the ASA?
0 Yes
OYes
0 No
0No
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?
OYes ONo
Date Received:
Staff Representative
METHOD OF PAYMENT
VISA
❑ C.\SII ❑ CII1iCK ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
B.\NKC.\RD NU \IBI?R:
\UTI f(RI/I-,D SIGN.\TURF:
SUBTOT.\l.
TOTAL FEE
MINIMUM PERMIT FEE IS $35.00PI EASE
MAKE CI II :CKS PAYABLE TO SPOK (NE
COON lY PERMIT CENTER
CHNSON ADDITION
0
0
tit
0
89' 9'24" E
8 .89'
z
00
00
14 895706 W
84.88
$:
z
0
0
S 895410 E
N 89' 5607" W
138.83'
Jo
N e95a*34- w
138.84'1k 8 69.429'5834" W
41"..
.41
0
z
TRACT A
8815 E. BOONE
135410 SO FT
--
ewo—Ert use.—roa
N 9C1'00'00' E
80.00'
1.4
0 SET 5/8" REBAR
STAMPED "DURYE1
FOUND SPOKANE
AND WASHER
BASIS OF BEAR
TRACT B VI
8821 E. BOONE 6
I 1432.1 SO FT .
BOONE AV NUE (40' ROW)
N 171014" W\
36.63
• CLi-')
I
4
re)
DEDIC
SPOK
T
NE COUNTY
a
THIS SUFli
RVEY WA
TOTAL STATION USING
ACHIEVING MINIMUM CLO`,
N 332-130-090.
THIS PLAT CORRECTLY F
OR UNDER MY DIRECTIO
REQUIREMENTS OF THE
ORDINANCE.
MITCHELL DURYEA, P
6CERTIFICATE NO. 33 58
DATE
MI CH LL DURYEA, PLS
BRAWN BY
SURVEYED I
11101V
KAT FALLS
POKANE
LEWISTON
k5‘
Pg-e-po
vs;..
.C?
ADDRESS g
zONE - A
ROAD WC1 `141/
FRO
COMMEN
REVIEWED b
This site plan is being submitted for thepurpose of
obtair:Ig odg permit and is a true and correct
represer:aion of the proposal. All known property
linesidiniensions. curb lines, structures and easements
have teen identified. Also indicated are wetlands,
bodies of water step siope r ot,har critical areas.
Signed:
Date:
•
St
My Appoin
AFTER RECORDING MAIL TO:
Pacific Northwest Title
120 West Cataldo Avenue, Suite 100
Spokane, WA 99201
Filed for Record at Request of:
Pacific Northwest Title Company of Spokane, Inc.
Space above this line for Recorders use only
MANUFACTURED HOME
PLEASE CHECK ONE
` `""�'"�
IILC IU J APPLICATION
Anyone who knowingly makes a false statement of a material fact is guilty
of a felony, and upon conviction may be punished by a fine, imprisonment, or both.
X
❑
TITLE ELIMINATION
TRANSFER IN LOCATION
REMOVAL FROM REAL PROPERTY
(RCW 46.12.210)
1
MANUFACTURED HOME
TPO/PLATE
NUMBER
YEAR
2000
MAKE
American
LENGTH/WIDTH (FEET)
52 X a
vcurrmEIDENTIFICATION NUMBER (VIN)
C16 ST6)0(; CO vi l‘k- t.
2
LAND LEGAL DESCRIPTION ON PAGE 2
MANUFACTURED
HOME WILL BE
X
AFFIXED ❑ REMOVED
REAL PROPERTY TAX PARCEL NUMBER
45181.2101
LOT
-rccLk-
t
IN
BLOCK
PLAT NAME OR SECTION/TOWNSHIP/RANGE
11 s 1soRyea
OUARTER/OUARTER SECTION
3
GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE
COUNTY
0148
NUMBER
NUMBER OF REGISTERED OWNERS
NUMBER OF LEGAL OWNERS
NAME
Craig
OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
R. Johnson
NAME
Jessica
OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
J. Verstelle
ADDRESS
8815
CITY STATE ZIP CODE
East Boone Avenue, Spokane Valley, WA 99212
NAME
US
OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
Bank
NAME
OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS
1550
CITY STATE ZIP CODE
American Blvd East Suite 440, Bloomington, MN 55425
GRANTEE
NAME
Craig
R. Johnson and Jessica J. Verstelle
I DO
THIS
SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I/WE AM/ARE THE REGISTERED OWNER(S) OF
VEHICLE AND THIS INFORMATION IS ACCURATE: �f
�j
Signature of Registered Owner and Title, IF APPLICABLE
Signature of Additional Registered Owner and Title, IF APPLICABLE e/ U.Q/>4-11t"'v
NOTARY SEAL OR STAMP i NOTARIZATION/CERTIFI ON FOR REGI ED OWNER(S)
State of Washington Signed or atte ted it,
Spokane
SIGNATURE
0 fl
v
County of before -.n
by Craig R. Johnson Signature ,,
, 72 , i % '
Notary
oto of
Public
Washington PRINT NAME OF REGISTERED OWNER NOTARY OR AGENT
by Jessica J. Verstelle Amanda R. Lyons
AMANDA
Iment
R. LYONS
Expires Mar 13, 201 0 PRINT NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY
County/Office No. OR
Title Notary AND Dealer No. OR 3/13/2010
DEALERSHIP POSITION/AGENT/NOTARY Notary Expiration Date
4
TITLE COMPANY CERTIFICATION
I certify
that the legal description of the land and ownership is true and correct per the real property records.
NAME
Tracey
(TYPED OR PRINTED) TITLE COMPANY/PHONE NUMBER
Olson, Pacific Northwest Title Company of Spokane, Inc. (509)744-3434
SIGNATURE/POSITION
DATE
Finalize
this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs.
5
BUILDING PERMIT OFFICE CERTIFICATION
I certify that: IV(the manufactured home has been affixed to the real property as described.
❑ a building permit has been issued for this purpose and the attachment will be Inspected upon completion.
NAME (TYPED OR PRINTED) BLDG PERMIT OFFICE/ HONE #
Ni lite —ro213 4,I ( etTy ®r Awe- 1 �, l We - 003 6
BLDG PERMIT #
0206o:6H tt-
SIGN TU /POS. 1TIj %�Sr ��, DATEto -ZooS,
TD -420-729 MANUF HOME APPL (R/2/02)OR (W)Page of
First American Title File No. SPO -1065190 (AL)