1993, 02-02 Permit App: 93000561 MHPROJECT NUMBER= 93000561
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APPLICATION DATE= 02/02/93 PAGE=
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 18825 E FAIRVIEW AVE PARCEL#= 55082.0144PTN
ADDRESS= OTIS ORCHARDS WA 99027
PERMIT USE= DOUBLE WIDE MOBILE HOME
PLAT#= 005165 PLAT NAME= MEADOWLARK ADDITION
BLOCK= LOT= 4 ZONE= UR -3.5 DIST#= G
AREA= 00019300 F/A= F WIDTH= 90 DEPTH= 219 R/W= 50
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
PHONE= 602 868 0701
OWNER= SUMMERS, PHIL
STREET= BOX 520
ADDRESS= FLORENCE AZ 85232
CONTACT NAME= GENE SIMPSON PHONE NUMBER= 208 773 3168
BUILDING SETBACKS: FRONT= 30 LEFT= 25 RIGHT= 10 REAR= 160+
****************************** REVIEW INFORMATION ************************
DEPARTMENT REVIEW COMMENTS APPROVAL COMMENTS
BUILDING SETBACK REVIEW REQUIRED
ENGINEER NEW COUNTY ROAD APPROACH
HEALTHDIST NEW OR ADDITIONAL WASTE WATER
&Plaited
r
****************************** MOBILE HOME PERMIT ***** ***
CONTRACTOR= GENE SIMPSON CONSTRUCTION
STREET= 2220 W HARMON RD
ADDRESS= POST FALLS ID 83854-0000
**************
PHONE= 208 773 3168
YR/MAKE= 1993 NAUSA MODEL=
SERIAL#= WIDTH= 28 LENGTH= 44 HEIGHT= 10
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 18.00
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME PMT 122.50 .00 122.50
122.50
.00 122.50
PROCESSED BY: BARRY HUSFLOEN
PRINTED BY: BARRY HUSFLOEN
******************************** THANK YOU *******************************
Sic 5 " 1t3 ea s
Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: \Z `-
CITY/STATE/ZIP: %.-XM
SUBDIVISION:
BLOCK: LOT: `7 ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: PHONE: LO - S t A - (')16 /
MAILING ADDRESS: 'Iyt S�
CITY/STATE/ZIP: ` S 3
CONTACT:
PHONE: �0` - 10SS
SETBACKS: - FRONT: LEFT: RIGHT:. REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
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CONTRACTOR: C . - a 1/Z � PHONE: - 113- 3 1 b cj
MAILING ADDRESS: �� d
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD:
BUILDING HGT: STORIES:
BUILDING DIMENSIONS: X '-I� (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: if HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
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ADDRESS;
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ZONE: 1,1 ` - .3 -
ROAD WIDTH:
FRONT:
COMMENTS:
REVIEWED BY:
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