Loading...
2001, 12-14 Permit App: 01010850 Relocate MHProject Number: 01010850 Inv: 1 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 12/14/2001 Page 1 of 2 Project Information: Permit Use: RELOCATION OF DOUBLE WIDE MANUFACTURED HOME Setbacks: Front 25 Left. 5 Right. 211 Rear. 20+ Site Information: Plat Key: 005799 Name: SP -777-92 Contact: CHD, INC. Address: PO BOX 13717 C - S - Z: SPOKANE, WA 99213 Phone: (509) 926-5229 Group Name: Project Name: District: F Parcel Number: 45134.2601 Block. Lot: SiteAddress 215 N GALLWAY LN VERADALE, WA USA 99037 Location:: VER Zoning: UR -3.5 Urban Residential 3.5 Water Dtstnct 010 VERA Area: 14,458 Sy Ft Width: 0 Nbr of Bldgs 0 Nbr of Dwellings: 0 Review Information: Owner: Name: CHD INC Address: BOX 13717 SPOKANE, WA 99213 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Site Plan Revi w Plan Review Special Reviews 1 Released By: "' Approach / Drainage Sewer Review Released BV 3 Um -roes lWto /44 O (- (0755 ca/J use sarre'r"170-DATA 1Trt:utn y"Fur caliasc. C.. tofo 154 c C____i\,4 4.4) I4/2of/0i Operator: RMB Printed By: RMB Print Date: 12/14/2001 Project Number: 01010850 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Permits: Date: 12/14/2001 Page 2 of 2 Contractor: WES CROSBY Address: P O BOX 13717 SPOKANE, WA 99213 Item Description INSPECTION FEE COUNTY SURCHARGE Notes: Payment Summary: Permit Type Manufactured Home Manufactured Home Firm: C H D INC Phone: (509) 926-5229 Units Unit Desc 2 SECTIONS 1 Y OR BLANK Permit Total Fees: Fee Amount $100.00 $22.00 $122.00 Fee Amount Invoice Amount Amount Paid Amount Owing $122.00 $122.00 $0.00 $122.00 $122.00 Disclaimer: Submittal of this application certifies the owner contained within to he true and correct, a complied with. Su se 9-. t issuance of provisions of the o, ,d of an othe Signature: $122.00 $0.00 $122.00 person(s) authorized by the owner) has both examined and finds the information that all provisions of laws and/or regulations governing this type of work will be all not.he contrued to be a permit for, or an approval of, any violation of any of the rr ordinances. Operator: RMB Printed By: RMB Print Date: 12/14/2001 �t ASPOKANE SPOIct ty COLNIY PROJECT APPLICATION WORK SHEET COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 \VEST BROADWAY AVENUE SPOKANE, \VA 99260 509-477-3675 , Vt p�17. SPECIFIC SITE INFORMATION Street Address: / % 3 Z2 �;��'%�i� ell Assessor's Tax Parcel Number(s): , / 31./. z G o ( Legal Descnption: �n/ /j 1%'st 4 Project Description: ,PrP Building Permit O Change 111 Use O G radmg IOf Manufactured Home Permit O Relocation O Sign O Tenant (New/Change) O Other Department Use Ori1y ': Phone 9.2g- 3 7 j ra. O Applicant Phone las Water ITstrict/Pun eyoe - Sewer D,<trict/Pur.crnr -- - - . Road a dth -. - s Setbacks ._ (s Fronr' Left. • . - < Rear ;Y. - - Schn, d DI[Intt Vire Dtsmct- _ 'Zoning 1 i f% . 3,5 OWNER/APPLICANT INFORMATION 0 DxLmrc nhn !boulI be,on/.riled rrpurhnn iLv /,rola ❑ tMnor( 04 /,‘,R' deo? Phone 9.2g- 3 7 j ra. O Applicant Phone las Unfinished basumuni >y ft i.lading Addre,. /9?"/— 2. ret '1'utnl habunblt span. Al.uhng.\ddm.. Finished basement s9. it. r:,n, Stat ti gnacatad�r r:ir. State, hip D.ck sy it. Cosi nl protect CI cunt, .n„Phan. et/-Aa/.n. 99 se— 397,— Ia\ 97-4-6z9t— O Archmct; I nom,' Ph,an. ret, hl.ulmg addren Pe• gx /37/7' Mailing add,... (3.Sac Zip S n �� 9(92/ /. on. Stam ,p \\A S1 �.unr L��R c. �'N�ilv /a4 LC. (:(m(1,1 name PROJECT INFORMATION Building Information Budding height ti, peak # of ..woes Alan tit ,,,r.y ft Unfinished basumuni >y ft Dnnenuuns '1'utnl habunblt span. 2nd (lour sy It Finished basement s9. it. ( )ccupancy group Constmawn npc Garage a1 It D.ck sy it. Cosi nl protect I Teat ..Dura- (clectnc. gas, etc) ManufacturedI-Idnie.' " '; rt', : Sign'""" Width. 000'CCCT... ^I/ - / Y IXl Y Aq the What is the square footage of the sign fact? I low high is the sign? /Yi— Year ��G� a Are critical or havardous matt nals used or stored on sue) 0 Ycs 0 No Make: # of signs Arca of esutmg signs Fireworks display / q P eilit-174frriget 4--1' Phone ❑ Concrete Relocation.. 'Non -Residential Energy Code Compliance? :- - { Fin Name \VIi1t is the eunent use of this property? Fire Safety. \\41l the site be screed be a septic system? ❑ Yes ❑ No Previous address ou // ` 1 / 4// ��G� a Are critical or havardous matt nals used or stored on sue) 0 Ycs 0 No Fire Spnnkler "Pent Paint booth Fire Alarm Fireworks display _ Proposed use Phone ❑ Concrete ❑ Welding ❑ Bolting Value Address 7. Special,Inspectlons Required? 'Non -Residential Energy Code Compliance? :- - { Fin Name \VIi1t is the eunent use of this property? Phune \\41l the site be screed be a septic system? ❑ Yes ❑ No I'Inns Examiner Phone Inspectnr. Is there evidence of fill or excavation 00 the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( /a/o) 0 Yes 0 No Are critical or havardous matt nals used or stored on sue) 0 Ycs 0 No Address Is the property located within 1000 feet of a Natural Resource Arca? ❑ Yes ❑ No ' Inspector Phone ❑ Concrete ❑ Welding ❑ Bolting ❑ Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures 00 the poi -terry? ❑ Ycs ❑ No If yes, zdenkiji on .v/e plan What is the current purperty swe? (slimly feet or acres) Is any part of the pmpetty within 250 feet of a shoreline? If Iyer, identify an si/e plan ❑ lyes ❑ No \VIi1t is the eunent use of this property? Is your property to a designated wildlife habitat area? ❑ Don't know ❑ Yes ❑ No \\41l the site be screed be a septic system? ❑ Yes ❑ No Is any part of the property within a 100 yr flood plain? ]l yes. iden/;6' on me plat ❑ Maybe ❑ Uon•t know 0 yes 0 No Ate or will there be \\ells located on the pmpetry? If Iyer, identify on /be site plan ❑ Yes ❑ No Are there any wetlands, streams or ponds within 200 feet of the property? If fes, Idendfv OA Jdeplan ❑ yes ❑ No Is there evidence of fill or excavation 00 the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( /a/o) 0 Yes 0 No Are critical or havardous matt nals used or stored on sue) 0 Ycs 0 No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Arca? -. ❑ \'cs O No TOTAL FEE ,;IINUIUir PERMIT FEE IS ijS.MPI.ILUO m tkr Cnl1CKs PAVANE, 1() 4Y5F.t]li Coc:N I V1'1.10111 I_I N' 11 11 is public sewer avadablc to the site? O Yes ❑ No- Is the property inside the ASA? . ❑ Yes ❑ Ycs ❑ No ❑ -No : Is public water available to the site? ❑ Ycs ❑ Nn - Is the property inside the PSSA? " ❑ Ycs ❑ No Is the property located within 1000 feet of a Natural Resource Arca? ❑ Yes ❑ No ' Date 0ecened Starr itt preseman, e METHOD OF PAYMENT VISA ❑ (:.\SII ❑ CI INCK ❑ D 4 FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DIJCWVER RANKC.\RD NUN! ISI Nit. EXPIRES ANTI I(lltl%I'.I) SIGN.NTI lit II SU IVI( )T,u. TOTAL FEE ,;IINUIUir PERMIT FEE IS ijS.MPI.ILUO m tkr Cnl1CKs PAVANE, 1() 4Y5F.t]li Coc:N I V1'1.10111 I_I N' 11 11 'Deparbnf.Lab entoor&dndustnes : FactocAisembled Structures•Stztioii INSTRUCTIONS:: -1.•'LComplete lall spaces, including.the sJgna(ure box (markedwitlfah X): eioi vtV t;:iosd 2. tDraw.a map ontreyerse side of WHITE opy only: VAC y^yac3 3. - Forward completed permit'aod fees to the:nearest L&I office'CSee Iistlon reverse.: • 4. ,Contac[ and schedule the lnspectiomwjtli the sameL&I ofHwithin IS�day�v:SP01j.-, , • :r 'ERATIONPERr% 1. •' Do not complete shaded areas• /�� tertoit # .4•;, 9s .:--. 1 6O] Owner 2-elast name . 1442E8 first name• -: -.,4-1 Day Ulne phonel,o'ai 2tc I W::;',..• . Address ,.:., v..;. �._ .w ,stew t.0 ..out, E.+KE'r:EN�j?"p (� r] u'F.ni [. "p•,'ri ;e Ci[y ,`� ., /-/1/1r, \ ii'' •+MV et9137g01j On 3$I-' ++ •ISt •i .,_ : x (20 P"4-1.2 •3S%a/':7 -' • m+IP sthi MZIPOte3-55ge • 18 Maltnwlly rt < Contractor's registration number /'A�MSt�ate„\\CLM`ZIP+;4'S,'3"t0R • Installer/Contractor/Dear- _ ..... _ . `,aPlwne ot,ncu ..`•- �v.• my rsn.:« - r/^�� .?,.. u..IPe,.y /2 '77 7 ,Ycmitin,cF ti,Y.dri?3Q-leg' �}f�,'vS �V,-d83QS Vi+SR Check theappropriate boxes In section. A•arid'�section B: ?.i>: �” '="""% d t r "" "'";� �: PEES' Ata 1171-44 i . • 1.1 Commercia,CoacF �,Alteration Ins ection (check aPDro riateboxes below) '$ • p1e 1S0flr • LJ Mobile Home'• Serial No. vPra9ccu,.n,,..-- 1,0 13<•! .,• o-" ""--X:?�?i rv�„�yr'?{'s3t,at�^r;t;:xst, 1- 3V • g12/KM! VIsEKDEI•%f. '.' °3E'*t;'.' :: '' n`.r'.'t°'9.1. Paw`. f.'£f�;;i "uli-. Recreational Vehicle or. -D -Park .TrailerL_ 4-353 .RAEKFila'= THUD No Sal NO: Model No:' or Plan -Approval No:li, p' -=r ,itl:to, :Air,Coaditioning/I-Ieat Pump . . 9P.wb!” mV 682( 1820 ©:EloeCrtnlvc311,lvMnVdR 10;0133' ) 1,0 Urtta:r0: ■;ElerliFir,A;phan.ces,a_ `°acti(titdig.iu!- ^1 14v-,`-". E' 4" :-,ctt.31011 1459iiF, ■ *FireSa"fet' ',';k :� .. i?;r,(w3klfO,,JAcjnto 2o■F• ■,GsPipngm'A83Si:2200. !Ain ue43494u ori •.rmlcRegpadt g,c Ll,.;'. d 3R(rn(?'nrmnn_lX ■ PltwmbiiPAiasHpH _u r' uucm;ry , A Wood/PetletStove' . P. an pRevewattlrr 0tgc12 •E Y RV,Inspection ; Relnspection:.=5 .. SerialNo fl Technical Inspection , n r" ..• .:. • . ... Note: =-This permit expires. one year afte"r•date`of purchase::"(Non-refundable) < •, Ongmal Permit No.'x»3 Signature ofap/plicant or au o p csentative,•_•,: -• `-N •�„h..�.` ser\, Depart(nent ascent Make 'check `payable'to:'.Dept. of Labor&•Industries ' • -FEES DUE:'.$ir< .lt:. - - : P cari`rrRar'�rceecneae,uds.gt•a^enpdprrregoitvnuess4.r:He.re.-tsr3:.dpWWecornL . _ysiteque,sq:t ;ddeennyliee`.d:X ,wcrfti'. '�CS<..M: Y�lm!wW wWnrequstedwithfu'lbayeccr(ou�reayocspc a:Favacldons lnW.O 20_ahlyngfornnmlbesila-bd5r Aeflaguand...xYTn:a':smey*Vmxeerc aloato723wns:_a't" smus 6thtgNce.voaHkd*(••%oea noe;en,-r :non-c%mplyingmobile home;commercial coachor recreationalvehicl.: aaY .t 'CALL•324-2640 FOR AN INSPECTION PLEASE, LEAVE NAME &'- : , ',. ALTERATION PERMIT NUMBER' tc,i l!ncluded are foitris requited;which must be completed and'fees submitted bt fore reinspection . > ' 'ti:Area office F622-0'2-000. alteration permit `_ 8-99 :•;.White-Olympia•!Canaiy-Inspector:Green-Contractor;; Pink -Purchaser Goldenrod=Purchaser; 974/91 It ESS2.15 1G a3 I5 D WIDTH3O RONT 25 FLANKING iMEN ;,LiJIEWE This site plan Is being submitted for the purpose of ening a bi,"firp rem;: and is a true and correct rcpiesentaticn of the prcpa=al Ail known crcperty "nes/dimensions, cute !Ines. structures and easarnents f>:e been identified Also indicated are rcdies of wate-. , ee; slopes or �A' areas Signed: Date: 12,/frit-c-*oiD /?/)/yS/3y. z(oat CH tie Ade r S, 2 77'-9a