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2002, 09-16 Permit App: 02007974 MHProject Number: 02007974 Inv: I Application Date. 9/16/02 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: DOUBLE WIDE MANUFACTURED HOME Contact: CI -ID INC Address: PO BOX 13717 C - S - Z: SPOKANE, WA 99213-3717 Setbacks: Front 25 Left: 30 Right: 54 Rear: 30 Phone: (509) 994-3972 Group Nanic: Site Information: Project Name: Plat Key: 005799 Name: SP -777-92 District: F Parcel Number: 45134.2603 Block. 12 Lot: SiteAddress. 207 N GALLWAY LN VERADALE, WA USA 99037 Location:: VER Zoning: UR -3.5 \Vater District: Urban Residential 3.5 Owner: Name: CI -ID INC Address: PO BOX 13717 SPOKANE, WA 99213-3717 Bold. ❑ Area: 14,449 Sq Ft Width 97 Depth: 148 Right Of Way (CO -30 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site flan Review Released By: _e..-1_63--ILLI...-LQ ✓_ L/ 2 - rQ 2 Plan Review Released 13y: _tri c-- (f -/7-Oz Approach / Drainage Released By:QLA Sewer Review Released y-e�� c -40t-43 » (O 2- — 7 c17 (o co -re ut-Roo Permits: Operator: CKF Printed By: CKF Print Date. 9/16/02 Project Number: 02007974 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 9/16/02 Page 2 of 2 Contractor: OWNER Item Description INSPECTION FEE COUNTY SURCHARGE Notes: Manufactured Home Firm: OWNER Phone: Units Unit Desc 2 SECTIONS 1 Y OR BLANK Fee Amount $100.00 $22.00 Permit Total Fees: $122.00 Payment Sununarp: Permit Type Manufactured Home Fee Amount Invoice Amount $122.00 $122.00 Amount Paid $0.00 Amount Owing $122.00 $122.00 $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 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: CKF Printed 13y: CKF Print Date: 9/16/02 A SrOkvyt CouNn• PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 \\'EST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Sheet AtIdtess: Assessor's Tax Parcel Numbet (S): 17/5—/ J5- /3 / Z-405 Legal Description: —23 Project Description: /.LA --t.) TYIia-a.�� /b` erg Y ' 1-0 ❑ Building Permit ❑ Change in Use ❑ Grading Manufactured Home Permit ❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other Department Use""Only " lihimc l a. ❑ Applicant. 'moi & Water Di.mct/Punepnr. Sever Dotdn/Purrcyor. . ' ' Road vidrh I'. •Setbacks . Iroir . 'Leri,'..n - Rear , . Right School Drvmcr. - Fire Distnct: - - .. Zoning t.-:-._- el"-Aee, — OWNER/APPLICANT INFORMATION !nrli,vte n bo dum(l be mnIkie l rrcarrlin! 11,11 pnynl ❑ 1lvncr F/415 kg lihimc l a. ❑ Applicant. 'moi & phone yy39-7'L l,, Aknln,y..) e. �r /; 7/7 !AIcaa Uitnensinns mailing Addre.. 3'w Boor sq. ft K( Co', Stale, Lip �/ 0 ItYY ( lccup.Ina' group Coy, State, rip Garage eq. ft. el"-Aee, — ❑ Conunno( cI%,w Phnne Vii_ 3572._ Fa‘92A-6, -z9 -L ❑ ,\mhima/lingineer Phone la. Al.ulmg addre, A0 L /3/ Mailing addre.. Sone Zi �. F9- 2-73 cit sum'%ip \VA Slat,: is „il e„ r l,rL,i,e nide, ii.,i L PRO IECT INFORMATION Building Information 7 •. Budding height Di peak 14 of stones Main Boor sq 6. Unfinished basement sq. ft. Uitnensinns I utas habitable space 3'w Boor sq. ft finished basement sq. ft. ( lccup.Ina' group Conal rLi't type Garage eq. ft. Deck sq ft. Coal of pn qr ct I Teat source (electric. .ga.. Ltc) Manufactured Horne ISigi Width "-L d (/ Length it (01/ ` What Is the square footage of the sign face? How high is the sign? Year 7� 00 i___ Make R .,.0--+-_. # of signs Ares of existing signs Inpertorc Proposed use Value Relocation Fire Safety Non -Residential Energy Code Compliance? ' Previous address U/f.G�. l I4 re Sprinkler Tent Paint booth lire :Mann ham elks display _ Inpertorc Proposed use Value Special Inspections Required? What is the current property sive? J (square feet or acres) /93ef7 Non -Residential Energy Code Compliance? ' FirmName U/f.G�. l Is your property in a designated wildlife habitat arca) ❑ Don't know ❑ Ycs bcNn Phone Is any part of the property within a 100 yr Flood plain? fj'es, ldent onsite plan 0 Alaybe 0 Don r know 0 Yes WNo Plant, Fxam€ner / Phone Inpertorc Are there .dopes greater than 30 / on the property? (30 Et rise in 100 ft) ( /'/.) 0 Yes ' No Arc cuncal or halal duos materials used or stored on site? 0 Yes W -No Address Inspector Phone ❑ Concrete ❑ Welding ❑ Bolting ❑ Reinfo¢crnent Address ADDITIONAL SITE INFORMATION Are there structures on the property? O Yes 'ck,No Ifyes. ,deny on Me plan What is the current property sive? J (square feet or acres) /93ef7 Is any part of the property within 250 feet of a shoreline) If yes. Identify on rilephnt ❑ Ycs I Vo \Wha: Is the current use of this property? _,[_ U/f.G�. l Is your property in a designated wildlife habitat arca) ❑ Don't know ❑ Ycs bcNn Will the site be served by a septic system? O Yes No Is any part of the property within a 100 yr Flood plain? fj'es, ldent onsite plan 0 Alaybe 0 Don r know 0 Yes WNo Are or Will there be wells InCa;ed on the property? kin. identify on the sae pl til 0 Yes �y No r` Are there any wetlands, streams or ponds within 200 feet of the property? Ifl'es, ldenlj' on site ph L/ 0 Yes I No is there evidence of fill or excavattnn on the property) 0 \es 1 No Are there .dopes greater than 30 / on the property? (30 Et rise in 100 ft) ( /'/.) 0 Yes ' No Arc cuncal or halal duos materials used or stored on site? 0 Yes W -No DEPARTMENT USE ONLY •I' the property in a designated Stonnwater Control Area?' •- .• - 0 Yes 0 No is public sewer available to the site? 0 Yes 0 No 'Is the property inside rhe ASA? - .. 0 Yes ❑ Yes 0 No , ❑ No Is public water available to the site? 0 Yes 0 No Ts the property inside the PSSA? 0 Yes 0 No - Is the property located within 1000 feet of a Natural Resource Ares? O: Yes 0 No - Date Recened Staff Its pose m.nne METHOD OF PAYMENT ❑ C,\SII ❑ (:III - :K ❑ VISA MOWER FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DA'I I. I'.S1)1121 _ BANKCARD NUMBIR AUTI IORI%I fl) SIGNA I URII. SUIB'f(YI'.\I. TOTAL FEE MINIMUM' PERMIT FEE IS 53500PLE\SE ,MAKE. CI If,CIS RfUPI L I ll SPOK'NE COUNTY PIAMFI CEN IER ADDRESS2O1 0 ' ' /. V t .1 ZONE 2 ROAD 'VI Tli b l 5 FRONT FLANKING COMMENT REVIEWED No/%lf MAW/ AffAME 0.-61-0.4WC 84<37/7 t1149Q'13 This s::a pan is being submittei for the purpose of obtaining a building permit and is a true and correct representation of the proposal. All known property Imes/dimensions, curb tines. stpictures and easements have been identified, Also i�.1.' at • are wetla . =s, bodies of wgley gteep sl.nS' a .•.� -r al areas. Signed: 1-4-4,eAtf ej G° - 515/39.2.,‘63