1997, 04-29 Permit App: 97002662 MHPROJECT NUMBER= 97002662
PROJECT NUMBER= 97002662
APPLICATION DATE= 04/29/97
APPLICATION DATE= 04/29/97
PAGE= 01
PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 19218 E BUCKEYE AVE
ADDRESS= OTIS ORCHARD WA 99027
PARCEL#= 55082.1306
PERMIT USE= SINGLE WIDE MANUFACTURED HOME EXISTING ON-SITE SINCE 1978
PLAT#=
BLOCK=
AREA=
# OF BLDGS=
000136 PLAT NAME= BALLARD'S ADD. TO
12 LOT= 6 ZONE= UR -7
00000001 F/A= A WIDTH=
# DWELLINGS= WATER DIST
OWNER= MERRILL, DEAN
STREET= 19812 E BUCKEYE AVE
ADDRESS= OTIS ORCHARD WA 99027
CONTACT NAME= DEAN MERRILL
BUILDING SETBACKS: FRONT= 32
LEFT= 48
COLBERT
DIST#=
DEPTH=
G
R/W= 30
PHONE= 509 326 5920
PHONE NUMBER= 509 326 5920
RIGHT= 8 REAR= 18
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING
APPROVAL:
ENGINEER
COMMENTS:
HEALTHDIST
COMMENTS:
LABOR & IN
COMMENTS:
SETBACK REVIEW REQUIRED
OK PER SITE PLAN C.HARGRAVE DATE: 04/29/97
APPROACH/ DRAINAGE/ FLOOD
710
NEW OR ADDITIONAL WASTE WATER
STRUCTUAL ALTERATION
(Lpoirtett
40.2"/7 OM.
****************************** MOBILE HOME PERMIT
CONTRACTOR= OWNER
YR/MAKE= 1978
SERIAL#=
PHONE=
*********************
MODEL= BUDDY
WIDTH= 14 LENGTH= 67 HEIGHT= 10
PROJECT NUMBER= 97002662 APPLICATION DATE= 04/29/97 PAGE= 02
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
INSPECTION FEE 1 50.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 11.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 65.50 .00 65.50
65.50
PROCESSED BY: CHRISTY HARGRAVE
PRINTED BY: CHRISTY HARGRAVE
.00 65.50
******************************** THANK YOU ************************************
w
APPLICATION INFORMATION
"What is the JOB SITE address? ASSESSOR'S tax parcel number? litiaqb
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Legal description as it appears on the property deed
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OWNER or OCCUPANT Phone
DI -s-4 til A ,1nt, • /I co? 4.14-.S920
Mailing address City, state Zip
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Who should we contact regarding this project? Phone
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What work is being done under this permit?
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Lone ....
y
Inspector distnct
F roperty size
Right of way width
Water district
Building
Building height
# of stories
Contractor
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd floor area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
'Manufactured HomeSi
r g n
Width:
/ I e
!
Length:
7c a
What is the square footage of
the sign face?
How high is the sign?
Year:
1178)
Make: deo. feet.
4K1,py
Installer
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Relocation Fire Safety
Previous address
Fire Sprinkler Tent
_ _
Paint booth _ Fire Alarm _ Fireworks display _
VALUE
Contractor Contractor
WA State Contractor license # WA State Contractor license #
Mailing address 'Mailing address
Fuel Storage "Tanks Swimming Pool
(Circle one) Above -ground Underground Size / gallons
Private
Contents of tank(s)
Size / gallons
Public/semi-private
Contractor Contractor
Wa State Contractor license # WA State Contractor license #
Mailing address Mailing address
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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04 cgeyeAVO
Site Plan
70
(91
ts)
Pk
Pa'
q.°
4-
••••11.•
6
7a2
AbD/RESS 4.k -
ZONE
ROAD WIDTH
FRONT S2- FLANKING N
COMMENTS
REVIEWED BY Q.-- -
INCLUDE THE FOLLOWING:
O All roadways, driveways & easments
o Distances from center of roads, right of ways,
private roads & property lines
O All existing & proposed buildings
O Underground utilities
O North arrow
0 Septic tanks & wells