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2010, 04-19 Permit App: 10001048 MHProject Number: 10001048 Inv: I Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: 2009 26 X 56 FLEETWOOD Contact: PAGENSTECHER, GERALD A & WAND Address: PO BOX 583 C - S - Z: GREENACRES, WA 99016 - Setbacks: Front Left: Right: Rear: Phone: (509) 924-0860 Group Name: Site Information: Project Name: Plat Key: Name: Range District: East Date: 4/19/2010 Page 1 of 2 Parcel Number: 55192.0901 SiteAddress: 17314 E COACH DR Location:: CSV Block: Lot: Owner: Name: PAGENSTECHER, GERALD A & W Address: PO BOX 583 GREENACRES, WA 99016 - Zoning: MF -1 MF MDR District Water District: 134 CONSOLIDATED ID #19 Area: 8,564 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Landuse/Zoning/HE Conditions Released By: Sewer Review Permits: Originally Released: 4/16/2010 By: CJJANSSE Released By: APPLICANT TO CONNECT - OK TO RELEASE PERMIT PER B.URHAUSEN - UTILITIES - VIA PHONE - 4/19/2010 - MT Originally Released: 4/19/2010 By: MTURBAK Manufactured Home Contractor: YUKON TRANSPORT Firm: YUKON TRANSPORT Address: PO BOX 1330 Phone: (208) 699-1204 RATHDRUM, ID 83858 Item Description SETTING PERMIT Units Unit Desc 2 # SECTIONS Operator: JD Printed By: JD Fee Amount $100.00 Permit Total Fees: $100.00 Print Date: 4/19/2010 Project Number: 10001048 Inv: 1 Notes: Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 4/19/2010 Page 2 of 2 Payment Summary: Permit Type Manufactured Home Fee Amount Invoice Amount Amount Paid Amount Owing $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: JD Printed By: JD Print Date: 4/19/2010 Permit Center �d7��ne 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 Valley. (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org Community Development Manufactured Home Permit Application OTHER PERMIT NUMBER: t li`�j PERMIT FEE: SITE ADDRESS: r J 3) L F;ce ii C# -19R, ciY1 Cl2 E $ \" ig• q ASSESSORS PARCEL NO: LEGAL DESCRIPTION: Building Owner: Name: &ERJ4A k0 A_ Pil 6 ENcrEdiE4 _, Address: 17 3.2 0 E, COAcg- n R, C PO igex City:CgEE j �A E5 State: W, Zipgg17 Ji Phone: 54N _ q, L/ Fax: Contact Person Name:=AII� -l►a GENS7'l/iZ Phone: aj Q 67 - C/ ,i - (os lD' Describe the scope of work in detail: Contractor: Length: 5'6 Year:2 co Name: Vko Tzpsfaa 7 -- Septi S Address: Address: n/6 /33 0 City: n, , ,,1' State: _D Zip: 8,3 5 Phone: Fax: Contractor Lic No: Exp Date: / J& J r Mil D a —.2.8 —// City Business Lic. No: (;©1_ y,/ — 9S3 MANUFACTURED HOME Width: ,;z6f3ii Manufacture: Length: 5'6 Year:2 co Pit Set: Septi S LEE r c,e,, p Previous Address: Proposed Use: 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 bprocessed Signature Method of Payment: ❑ Cash Bankcard #: Authorized Signature: REVISED 8/23/2005 ❑ Check ❑ Mastercard Expires: Date 13• -APR -0/0 El VISA VIN#: 74" 31 Li CCACH De, pRcNfT F141A1/ INS I S I^ S �} 1 PLANNING DEPT. APPROVED B DATE: L< 1L0 l 1O