1997, 07-28 Permit App: 97005533 MHPROJECT NUMBER= 97005533 APPLICATION
PROJECT NUMBER= 97005533 APPLICATION
DATE= 07/28/97
DATE= 07/28/97
PAGE= 01
PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 1507 N GRADY RD PARCEL#= 55172.0503
ADDRESS= GREENACRES WA 99016
PERMIT USE= DOUBLE WIDE MANUFACTURED HOME
PLAT#= 003502 PLAT NAME= MISSION VISTA
BLOCK= 1 LOT= 3 ZONE= UR -7 DIST#= G
AREA= 00000000 F/A= F WIDTH= 78 DEPTH= 138 R/W= 50
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= HAUFF, SCOTT
STREET= 1507 N GRADY RD
ADDRESS= GREENACRES WA 99016
PHONE= 509 928 4331
CONTACT NAME= SCOTT HAUFF PHONE NUMBER= 509 928 4331
BUILDING SETBACKS: FRONT= 60 LEFT= 10 RIGHT= 50 REAR= 15
****************************** REVIEW INFORMATION ***++******+*+**+********+*++
DEPARTMENT REVIEW REQUIREMENT
BUILDING SETBACK REVIEW REQUIRED
nn __ APPROVAL: OK PER SITE PLAN C.HARGRAVE DATE: 07/28/97
(24v\ 4o2. lk0c L -'n • Lo\1/441- -
HEALTHDIST NEW OR ADDITIONAL WASTE WATER
5ewoge:trctem designed
COMMENTS: for bedrooms only.
el 2)7
qa
so\ N . MArcoe. ‘‘y: c k r .
LABOR & IN STRUCTUAL ALTERATION
COMMENTS:
****************************** MOBILE HOME PERMIT ****+******+++***+***++**+.+**
CONTRACTOR= OWNER PHONE=
YR/MAKE= 1975 MODEL= FLEETWOOD
SERIAL#= WIDTH= 14 LENGTH= 70 HEIGHT= 10
ITEM DESCRIPTION
INSPECTION FEE
COUNTY SURCHARGE
STATE SURCHARGE
PERMIT TYPE
QUANTITY FEE AMOUNT
1 50.00
Y 11.00
y 4.50
FEE AMOUNT AMOUNT PAID AMOUNT OWING
PROJECT NUMBER= 97005533 APPLICATION DATE= 07/28/97 PAGE= 02
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 65.50 .00 65.50
65.50
PROCESSED BY: CHRISTY HARGRAVE
PRINTED BY: CHRISTY HARGRAVE
.00 65.50
******************************** THANK YOU ************************************
(Total pages
Canary -Inspector Pink-Purehascr Goldenrod -Purchaser
ol,gyor 1 industries , ,s ;r ALTERATION PERMIT
A{>lanblod Stmc[ures S [`'ptoypnply tAy'��j```��t 1[pq�i,�J`tp� {p[1p� ' r � .\) II I�Do not complete shaded areas
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... 1eomplete all spaces, including the signature box (ma ked with an X).
4fhat► a map on reverse side of WHITE copy only.
ti
4Forsrard completed permit and fee to the nearest L& office. See list on reverse.
Contact and schedule the inspection with the same L&I office within 15 days.
last name
J•
t.
•
first name Day time phone
( )
Invoice
Insignia
L
Date
City State ZIP
Installer/Contractor/Dealer
Phone
( )
Contractor's registration number
Address
City State ZIP+4
Check the appropriate boxes In section A and section E.
A •❑ Commercial Coach
Serial No.
EJ Mobile Home
Serial No. '
}IDD No. •
Recreational Vehicle or U Park Trailer
Serial No.
Model No. or Plan Approval No.
FEES
Alteration Inspection (check appropriate boxes below) $75,00
Air Conditioning/Heat Pump PAID
Electrical
Electrical Appliances DEPARTMENT OF LABOR & INDUSTRIES
Fire Safety
Gas Furnace
Gas Piping
Plumbing
Structural
Wood/Pellet Stove — -
Plan Review
RV Inspection
Reinspection
Technical Inspection
JUL 2 81997
REGION 6
Serial NoSNOKANE,,.WA
Onginal Permit
No.
$70.00
$70.00
$50.00
$50.00Au
Signature of applicant or authorized representative
Make check payable to: Dept. of Labor & Industries UV
FEES DUE $ 7
De artment use only '.
Request approved: or c❑' Request denied because of specific violations of Washington rules and regulations:;,Viidations
must be corrected and reinspection requested within 10 days for recreational vehicles and 20 days for Mobile•homes•and
commercial coaches'or the notice of violation date. (This does not apply to technical inspections). It is unlawful Lo offer for sale,
rent, or lease any non -complying mobile home, commercial coach or recreational vehicle.
raj Included are finis required which must be completed and fees submitted before reinspection.
( Date
Arca office
Inspector
F622-012-000 alteration permit 4-96
White -Olympia Green -Contractor
S7 '
GRNPY
X Iv°
rip
ADDRESS: kfz'1 • 4"d''S"'"�
ZONE: Lk -Q- t
ROAD WIDTH: So
FRONT_ FLANKING: N-�p!►-a•
COMMENTS:
REVIEWED BY•C.• •
I I r.l t i t i io
uy
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