2004, 03-16 Permit: BLD-04-03782 MH Safety InspectSpokane e�
at,�valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
Job Address:
Description:
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
MANUFACTURED HOME PERMIT
1501 N GRADY RD
GREENACRES WA 99016-9468
SAFETY INSPECTION OF EXISTING SINGLE WIDE MOBILE HOME SINCE 1984
W/NEW FOOTINGS
BORTH, ADOLPH & DORIS
Permit #:
Applied:
Issued:
Expires:
Lot: Blk: Parcel No: 55172.0504
BALDWIN, BRUCE Phone: (509) 922-7400
721 N PINES RD
SPOKANE, WA 99206-4955
Phone:
Lic No:
BLD -04-03782
Zoning:
03/16/2004
03/23/2004
09/19/2004
General Information:
SECTIONS
YEAR BUILT
DIMENSIONS
# OF STORIES
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
MANUFACTURER
Fees:
1w PER SECTION FEE
1984
14 X 66
1
30+
15 min
30+
13 ,
FLEETWOOD
Total Calculated:
Deposits/Receipts:
Total Due:
50.00
50.00
50.00
0.00
Disclaimer:
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.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name
Staff Initials
`)
Signature Date
THIS IS NOT A RECEIPT
Spokane
jValley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
MANUFACTURED HOME
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Application #: BLD -04-03782
Job Address: 1501 N GRADY RD Applied: 03/16/2004
GREENACRES WA 99016-9468 Issued:
Description: SAFETY INSPECTION OF EXISTING SINGLE WIDE MOBILE HOME SINCE 1984 Expires: 09/12/2004
W/NEW FOOTINGS
Subdivision:
Owner: BORTH, ADOLPH & DORIS
Lot: Bik: Parcel No: 55172.0504 Zoning:
Applicant: BALDWIN, BRUCE Phone: (509) 922-7400
Address: 721 N PINES RD
SPOKANE, WA 99206-4955
Contractor:
Address:
Phone:
Lic No:
General Information: Fees:
SECTIONS 1w PER SECTION FEE 50.00
YEAR BUILT 1984
DIMENSIONS 14 X 66 Total Calculated: 50.00
# OF STORIES 1 Deposits/Receipts: 0.00
FRONT SETBACK 30+
REAR SETBACK 15-26 MIN
LEFT SETBACK 30+
RIGHT SETBACK 13
MANUFACTURER FLEETWOOD
Total Due:
50.00
:CRY OF„SPOKANE VALLEY
APPROVED FOR SUBMITTAL
Initials /Date
Building
Planning
Public Works
1'
THIS IS NOT A RECEIPT
03/16/2004 13:48 5093241567
MAR 16 2004 12:03 FR
ars or
14'., 1 311
aosinalley
11707 E. Spnaeue Ave.. Suite 106
Spokane Valley, WA 99206
Job Address:
Descrpton:
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
1501 N GRADY RD
GREENACRES WA 99016-0468
MOBILE HOME SINCE 198
SRHD EHS
TO 3243.vorr
MANUFACTURED '\HOME
i
r . v
PAGE 01
a• w
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
SAFETY INSPECTION OF EXISTING SINGLE WIDE
W/NEW FOOTINGS
BORTH, ADOLPH 8 DORIS
BALDW IN, BRUCE
721 N PINES RD
SPOKANE, WA 90206-4985
Lot:
BIS:
Phone:
Phone:
Lic No:
Application p:
Applied:
Issued:
4 Expires:
Parcel No: 66172.0504
(509) 922-7400
BLD -04-03782
03/161200'
09/1212004
Zoning:
General Information:
SECTIONS
YEAR BUILT
DIMENSIONS
# OF STORIES
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
MANUFACTURER
1w
1984
14X66
1
30+
15,2B MIN
30+
13
FLEETWOOD
Fees:
PER SECTION FEE
Total Calculated:
Deposits/Receipts:
Total Due:
50.00
50.00
0.00
60.00
E VALLEY
APPROVp FOR SUBMITTA
In'rlwl s
sdlate
Building
Planning
Public WBrtts
• il.r
(i
•
THIS 18 NOTA RECEIPT
MAR 16 2004 13:45
509324156?
PAGE.01