2013, 10-16 Permit App: FAS-2013-0021 Fas PlacementSpokane �
jUalley�
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
perm itcenter@ sooka neva llev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
MANUFACTURED HOME PERMIT APPLICATION
OTHER
SITE ADDRESS: /' _4%i Gr/ Zcne._
ASSESSORS PARCEL NO.: -co 3 LEGAL DESCRIPTION:(
BUILDING OWNER NAME:
NAME:
ADDRESS:
CITY:
Gyho(e.h zVwd1anSee_
STATE:
ZIP:
PHONE: 5—Q 307- 58517
FAx:
CELL:
CONTACT NAME: Pe.GIa/aii1905eh
PHONE:
9 -?$3 -3923 `
CONTRACTOR NAME: "55;,),1deed ow_5 LLC (1- nd G)1,0,16--
FAX: CELL:
MAILING ADDRESS:
5V0 F-, i1ev�vr Cf'
CITY: t)/:f P ✓ J/
PHONE: N%_ 9 3 -? 7 3
CONTRACTOR LICENSE No.:
STATE:
FAX: CELL:
ZIP: 9�037
EXPIRES: 5/3ihy CITY BUSINESS LICENSE NO.: (op/ 9 5 Ozi
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
SP f j10.u) plant, {i1e/lid J'k7/7�P
602 -
MANUFACTURED HOME WIDTH: Z(0/- 8//
MANUFACTURED HOME LENGTH:
YEAR OF MANUFACTURED HOME:
PIT SET: yP5
MANUFACTURER: L P,P_./
PREVIOUS ADDRESS: "4)
PROPOSED USE: 2QS%G et
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submitted and subsequently approved before this application can be processed.
Signature _ .. Date: *
'1 Or '/,/2o/3
/vii
Z0/3
C7
f i U�eS
EWER:
(
Updated 1-11-11 Page 1 of 1
http://www.spokaneval ley.org/filestorage/124/938/210/948/1496/Manufactured_Home_Permit_1-11-11.doc
D
co
D0
LOT 37
1839 N. Grady Lane
Prepared for: Lynden Woodmansee
North
Scale: 1" = 20'
Home Manufacturer: Valley Quality Homes
Width: 26'8" Length: 60'
Resident approval of site plan
Signature
Signature
date
date
X Cla
BALDWIl
LANE q
Owe
orma
NI
4tt
c,$)