2003, 03-27 Permit App: 03002044 MHProject Number: 0300204-1 Inc: I
Application
Date' 3/27/2003 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW DOUBLE WIDE MANUFACTURED HOME
REPLACEMENT
Setbacks Front 30 Left: 31 Right 17 Rear: 25
Site Information:
Plat Key:
Name:
Contact: ALL SEASONS EXCAVATION
Address: POB 14978
C - S - Z: SPOKANE WA 99214
Phone: (509) 455-9285
Group Name:
Project Name:
District: G
Parcel Number: 55064.0602
Block 5 Lot: 2
SiteAddress' 3410 N DON WOOD ST
SPOKANE, WA USA 00000
Location:. SPO
Zoning: UR -7
Water District.
Area: 9,375 Sq Ft
Urban Residential -7
Owner: Name: PROVENCIO, ROBERT
Address: 19625 E WELLESLEY #83
OTIS ORCHARDS, WA 99027
Hold ❑
Width: 75 Depth: 125 Right Of Way (ft): 50
Nbr of Bldgs' t Nbr of Dwellings: 1
Review Information:
Review
Site Plan ReskCW Released By.
Septic System Review
Permits:
,Released By.
wage system designs for a maximum oi_ .. _
bedrooms, or 9Gd na'inn- P9f do .
OCCUPANCY NOT ALLOWED until system
installation has SRHD eoprov;;l.
Operator RMB Printed By: RMB
Print Date 3/27/20113
Project Number: 03002044 Inv. 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date 3/27/2003 Page 2 of 2
Manufactured Home
Contractor: ALL SEASONS EXCAVATION Firm: CLAY CLACEY/ALL SEASONS EX
Address: PO BOX 14978 Phone: (509) 922-4135
SPOKANE, WA 99214
Item Description
INSPECTION FEE
COUNTY SURCHARGE
Notes:
Payment Summary:
Permit Type
Manufactured Home
Units Unit Desc
2 SECTIONS
1 Y OR BLANK
Fee Amount
$100.0()
$22.00
Permit Total Fees: $122.00
Fee Amount Invoice Amount
$122.00 $122.00
$122.00 $122.00
Amount Paid
$0.00
Amount Owing
$122.00
$0.00 $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 he
complied with. Subsequent issuance of a permit shall not he construed to he 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 RMB Printed By: RMB
Print Date. 3/27/2003
rrrr
SPOIL COUNTY
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description:
TYPE OF APPLICATION
❑ Building Permit
El Change in Use
El Grading
'Manufactured Home Permit
El Relocation
❑ Sign
❑ Tenant (New/Change)
El Other
SPECIFIC SITE INFORMATION
Street Address: �e7//Q cc"j.,7",.
co' - J__
�CJ74/
Assessor's Tax Parcel Number(s): 550(0/ I y DUO6�
`f
Ma, inn Address. / ��
/
4,,
Ma g Address'
Legal Description:
to
City, State, Zip /
Cuy, State, Zip
De arementr,Use:On .: ..._._._..:._............ _ ..::.:.:
:::;=:-:M:-,:e:�•-.:.:.
,..
tnc eyor
WaterDis[ne[/Purveor.':{-;•r•;:`-":-%•'wer
a:..
--
DisvicdPurve or;:::nuna:':'-I"xe,';,,,,Road
r..::.: :..: r:•a::..... •. •• ::P'?"
width
-
Setbacks
:'Fromix✓...
1d&' '
•
R• ear:
Righr,
.schoohDistr,rr. `:. ...aa; `.= c
l Fiie Distnm=`,i=ir ;n-:ar .:,;:�-e: ^r:i^t"
,:.. ..
t7onmg.:
Contact name:
OWNER/APPLICANT INFORMATION
El Indicate who should he contacted regarding this pro/ect
Owner. Phone :957_9(C
�Ap nt
Phone �
Ma, inn Address. / ��
/
4,,
Ma g Address'
Dimensions
to
City, State, Zip /
Cuy, State, Zip
Finished basement sq. ft.
❑ Architect/Engineer
Phone
hax
S"Comrac or t.--, Phone./s. -5/97
�
/��/ -_-err Fax 7i�z U— ��/3/•
Maylipgad. ss s�
Mailing address
Heat source (electric, gas, etc.)
G[ to "L,
City, Stale Zip
/
W.'tate Contractorcense p
J2 7o/G/
Contact name:
PROJECT INFORMATION
B'iul'd ri Irifor"mafiori"
Building height to peak
,y of stories
Main floor sq. ft
Unfinished basement sy ft.
Dimensions
Total habitable space
2"a floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq ft
Cost of project
Heat source (electric, gas, etc.)
Manufactured Home :; -; ::`
Sig n,
Width:
d
Length: a
/4571
What is the square footage of the sign
face?
How high is the sign?
_
Fireworks display
Year:
3
Ma15e/ iY f✓
,//
# of signs
Area of existing signs
Relocation
.
Fire Safety
Firm Name
Previous address
Fire Sprinkler
Tent
Paint booth _ Fire Alarm
_
Fireworks display
Inspectors.
Is there evidence_ of fill or excavation on the property?
0 Yes IFACNo
Proposed use
Value
Mks—
Address
Special' Inspections, Required>;, ° `"`" ', r::, -
,Non -Residential Energ: Code Compliance?
Firm Name
What is the current use of this property? -y
/C, t -r
Phone
Will the site be served by a septic system Yes ❑ No
Plans Examiner
Phone
Inspectors.
Is there evidence_ of fill or excavation on the property?
0 Yes IFACNo
Are there slopes greater than 30% on the propert(30 ft rise in 100 ft)
(/70 O Yes 151c No
Are critical or hazardous materials used or stored on site?
O Yes No ,
Address
Inspector
Phone
O Concrete
❑ Welding
❑ Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? ❑ Yes iRC.No
If yes, identify 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?
If yes, identify on site plan 0 Yes 2t -No
What is the current use of this property? -y
/C, t -r
Is your property in a designated wildlife habitat area?
0 Don't know ❑ Yes , No
Will the site be served by a septic system Yes ❑ No
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
0 Maybe 0 Don't know ❑ Yes a No
Are or will there be wells located on the property?
If yes, identify on the site plan O YestNo
/
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan ❑ Yes 9c No
Is there evidence_ of fill or excavation on the property?
0 Yes IFACNo
Are there slopes greater than 30% on the propert(30 ft rise in 100 ft)
(/70 O Yes 151c No
Are critical or hazardous materials used or stored on site?
O Yes No ,
7
DEPARTMENT USE ONLY
the property in;a esignate S[ormwlteContro Area.
:' : ' "'.'" :... s❑� Yes. :' f7;:
.. .. _ _ ❑''Yes?: ❑''; No.
':Ispu6lic sewei: available to the site?='��� ��;: �'.
:Nil -le -property inside the ASA?';.'
Is the property inside the PSSA?,
Is`public Wnier. aSa lable;toahe site?::
;Is the property located within_ 1000 feet$f.a Nattiral'Resource H
Area...•% ... .iiO
.. �... ;,'Yes.,, :,[]..No
Date Receives!
Staff Representative:
/FOAD WIDTH 500
BARKER 'R'D •'
,i/tAiP4 f?4-4 h.
•
fL /%GAYgte64;C� i/. _
AiDDRESS 1•1•34ib hetWet50
a0 N E (.1.Q_
/
CO FLANKING d `J
C OMMENT
EVIEWED B
FRONT OF HOUSE
�.o
w
This site plan is being submitted for tfin p o of
obtaining a building permit and is a tri c . representation of the propnsal All kngwr , roperty
lines/dimensions, curb linos. structur and easements
have been identified Also Indic -d a e wetlan
bodies of st=eo - • • her cri; : areas.
Signed:
412
----•-- - FENCE
7- EXISTING FENCE
\ I�
A
DONWOOD
c 7f-Odo.-J1-, (at
9c,a.27
Cy/P/
V%/1Ghl �t�Gt �✓1`�
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