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2013, 10-16 Permit App: FAS-2013-0020 Fas Placement
Spokane� jValley= Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 permitcenter@spokanevalley.org MANUFACTURED HOME PERMIT APPLICATION EI OTHER SITE ADDRESS: /13// ,a Ln ASSESSORS PARCEL NO.: 556g3 , gobb BUILDING OWNER NAME: LEGAL DESCRIPTION:ivt"5I3 NAME: ap Doyin /1t 1- /L$ ADDRESS: CITY: STATE: ZIP: PHONE: 5 (,7o 5-3 ?lo FAX: CELL: CONTACT NAME: K;,_,hgI Mac -0(1J PHONE: 5 C/ 5� 372 3 CONTRACTOR NAME: %1%15/ FAX: N4- CELL: py MAILING ADDRESS: /c We Er Cg /° ek--©k, STATE: W19- CITY: S,v/Lome i //€ vV /(9- ZIP: g' y PHONE: 9-)? 753 j 2 7 FAX: CELL: 5-41.-", 77o7 CONTRACTOR LICENSE No.: EXPIRES: 5/3/// (-71 CITY BUSINESS LICENSE NO.: k 0 DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: 5e -t- 1'�w fildna {�,� crir ✓ 1/r1 2 Vilheo--0 13 -cow MANUFACTURED HOME WIDTH: MANUFACTURED HOME LENGTH: YEAR OF MANUFACTURED HOME: PIT SET: *les MANUFACTURER: V41 ej &c.t4 ib 5 PREVIOUS ADDRESS: JV PROPOSED USE: 12e5i ,+il 2_z,"- ; /( too" -0" /0 13 SEWER) DISCLAIMER The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The 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 ,,A,7 Date: Od/(o/ 20/3 Updated 1-11-11 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Manufactured_Home_Permit_1-11-11.doc Page 1 of 1 LOT 43 1811 N. Grady Lane Prepared for: Don & Donna Gills North Scale: 1" = 20' Home Manufacturer: Valley Quality I lames Width: 26'8" Length: 60'0" Resident approval of site plan Signature date Signature date r . • i • • 60' 40.44• •. • • •.,.'... •. •••....•. 44 (S •