2009, 05-29 Permit App: 09001476 MHProject Number: 09001476 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/29/2009 Page 1 of 2
Project Information:
Permit Use: NEW 2004 27 X 48 GOLDEN
ESTATE/MANUFACTURING WEST INC
Setbacks: Front
Site Information:
Plat Key:
Parcel Number: 55083.9066
SiteAddress: 1722 N GRADY LN
Left: Right: Rear:
Name: Range
Contact: MISSION MEADOWS LLC
Address: 15918 E CAMERON CT
C - S - Z: SPOKANE VALLEY WA 99037
Phone: (509) 953-3923
Group Name:
Project Name: LOT 94
Location:: CSV
Block:
Lot:
District: East
Owner: Name: MISSION MEADOWS LLC
Address: 15918 E CAMERON CT
SPOKANE VALLEY WA 99037
Zoning: R-4 SF Res Urban District
Water District: 134 CONSOLIDATED ID #19 Hold: I_1
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: w;
Review
Building Plan Review
Released By:
SET PER MANUFACTURED SPECS
Originally Released: 5/29/2009 By: JLMain
Landuse/Zoning/HE Conditions
Released By:
Originally Released: 5/29/2009 By: mharnois
Contractor: OWNER
Item Description
INSPECTION FEE
Manufactured Home
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
2 # SECTIONS
Operator: jmm Printed By: jmm
Fee Amount
$100.00
Permit Total Fees: $100.00
Print Date: 5/29/2009
Project Number: 09001476 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/29/2009
Notes
Payment Summary
Permit Type
Manufactured Home
Fee Amount Invoice Amount Amount Paid
$100.00 $100.00 $0.00
Amount Owing
$100.00
$100.00 $100.00 $0.00
$100.00
Yl
Page 2 of 2
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: jmm Printed By: jmm
Print Date: 5/29/2009
Project Number: 09001476 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/27/2009 Page 1 of 2
Project Information:
Permit Use: NEW 2004 27 X 48 GOLDEN
ESTATE/MANUFACTURING WEST INC
Setbacks: Front
Site Information:
Plat Key:
Left: Right: Rear:
Name: Range
Parcel Number: 55083.9066
SiteAddress: 1722 N GRADY LN
Location:: CSV
Block:
1,44 tg
Contact: MISSION MEADOWS LLC
Address: 15918 E CAMERON CT
C - S - Z: SPOKANE VALLEY WA 99037
Phone: (509) 953-3923
Group Name:
Project Name: LOT 94
Lot:
District: East
Owner: Name: MISSION MEADOWS LLC
Address: 15918 E CAMERON CT
SPOKANE VALLEY WA 99037
Zoning: R-4 SF Res Urban District
Water District: 134 CONSOLIDATED ID #19 Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Building Plan Review
Landuse/Zoning/HE Conditions
Contractor: OWNER
Item Description
INSPECTION FEE
IReleased By: .,..
Released By: '- _j41,„1,...4 ..5 j99 9 J
Manufactured Home
Firm: OWNER
Phone:
Units Unit Desc
2 # SECTIONS
(000) 000-0000
Fee Amount
$100.00
Permit Total Fees: $100.00
Operator: jmm Printed By: jmm Print Date: 5/27/2009
Project Number: 09001476 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/27/2009 Page 2 of 2
Notes:.x�e�«.:;,,.,r
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: jmm Printed By: jmm
Print Date: 5/27/2009
, - Permit Center
Spokane 11703 E Sprague Ave, Suite B-3
www. snokaneval le v. o r> r VALLEY
Y" Spokane Valley, WA 99206 CITY Os bVU
4f Va11ey (509)688-0036 FAX: (509)688-0037
Community Development
Manufactured Home
Permit Application
PERMIT NUMBER: i' 174e,
PERMIT FEE:
SITE ADDRESS: 17 ZZ N. Grad Lam
ASSESSORS PARCEL NO: 55'083. 9044 LEGAL DESCRIPTION: �.OT 9�� /yJ/S5k 1 / OcvS n1Hp
Building Owner:
Name: /n/55je)n // (1/4I.)s LLL (tend owner
Name: Dave AO L ii I'I Ca /ar well
J
Address:
Zip:7 037
City: State:
Zip:
Phone: 193_ .9.07,./ Fax:
Contact Person
Name: 2c.,A a'S A615401'7
Phone: 5q— 953- 3
Describe the scope of work in detail:
Contractor:
Name: /n/55je)n // (1/4I.)s LLL (tend owner
Address: 15W6 R. CePhieelA t4
City:,, t1.4.ii t State: 1
Zip:7 037
Phone: `^ 9S'3- 'W23Fax:
Contractor Lic No: Exp Date:
City Business Lic. No:
Set filatue4dured Arne
MANUFACTURED HOME
Width: Z 7 /
Length: ve3/
Year: Zo/'
Pit Set: yes
-Septile€wer:
Manufacture: G.v/Q/e N 4-5/se / /j'�Aszu
Previous Address:
Proposed Use: ,z 5 PCe.4,1
daki n0 /,*Yet .fin c .
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 be processed.
Signature
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 8/23/2005
0 Check
❑ Mastercard
Expires:
Date
❑ VISA
VIN#:
Z7 Zoo
1722 N. Grady Lane
Scale: 1" = 20'
Home Manufacturer: 6-ol de.^ E-fajre.
Width 2-7' Length ¥S,
Resident approval of site plan
Signature Jdate Offr
Signature date