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2005, 01-03 Permit App: 05000003 MHProject Number: 05000003 Inv: 1 Apphcation Date: 01/03/2005 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: NEW TRIVET WIDE MANUFACTURED HOME Contact. RICHARD MASON y1inAddress: 15918 E CAMERON CT 0«� C C - S - Z: VERADALE, WA 99037 Setbacks: Front 6 Left: 7 Right: 20 Rear: 5 Phone: (509) 953-3923 Group Namc: Site Information:Project Name: Plat Key: Name: MISSION MEADOWS MHP MFG HOME PK 123 UNITS District: East Parcel Number: 55083.9601 Block: Lot: 61 SiteAddress: 1610 N GRADY LN Owner: Name: ROBINSON, ROLAND & CHERYL Address: 13920 E 28TH AVE Location:: CSV SPOKANE VALLEY, WA 99037 Zoning: UR -7 Urban Residential -7 Water District: Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 35 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: .. Review Site Plan Review Plan Review Permits: Released By: ai Manufactured Home Contractor: MOBILE CORRAL HOMES INC Firm: MOBILE CORRALL HOMES INC Address: 15906 E SPRAGUE AVE VERADALE, WA 99037 Phone: (509) 928-3003 Item Description Units Unit Desc Fee Amount INSPECTION FEE 7n SECTIONS _$4-50-00" /00, 60 Operator: K_C Printed By: DMD Permit Total Fees: -3-1-543-c /00. 00 Print Date: 01/03/2005 Project Number: 05000003 Inv: I i Application Date: 01/03/2005 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summary: : . .. . . Permit Tvpe Manufactured Home Fee Amount Invoice Amount $150.00 $150.00 $150.00 $150.00 Amount Paid $0.00 Amount Owing $150.00 $0.00 $150.00 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 he complied with. Subsequent issuance of a permit shall not he construed to he 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: K_C Printed By: DMD Print Date: 01/03/2005 Spokane Valley 05-- 0005 BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: /(v/D 4 c ady% La/ie. (; Assessor's Tax Parcel Number(s): 550 03 . 90(6- v� UD ` Legal Description: zO $ (o/ e isinz an 0/ Li 76, 1,1,5»v1 )Ve i%uls PERMIT DESCRIPTION: set files homt ❑ Building Permit ❑ Relocation ❑ Change in Use ❑ Grading Manufactured Home ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION ❑ Owner: £lam/ *Chet. / 44n,,Vl Phone: 9Z2..--lp5/ Fax: 2...7-3557 Address: /3 ZO E.. ZSR five c,mks,, I/%"1 ui/4 €792)37C State / Zip Code ❑ Contractor: AZ, (-p' {t{ Phone: ?ZS-30°3Fax: g9/ -/3/4f Address: /5-''040 8.4tra .e9 Spo /6.*2„t Vu l/r,� Wil- 9903? CSS oo State Zip Code WA State Contractor License #: ❑ Applicant: vfi1a///CYSoW1 Phone: 6/53-39Z9 Fax:L Address: /S9/off.srnarC / �v 9yo)7 State Zip Code 44, Architect: Phone: Address: Fax: City Contact: State Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: %�f-,, DIMENSIONS. 30 >c <oif # OF STORIES: / MAIN FLOOR TO SQ. FTG: 2N0 FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG. OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: # OF BEDROOMS: � J TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON- ITE EPTIC SYSTEM? /a !Z MANUFACTURED HOME Width: 30 Length: Coq Manufacturer: /Ua546(4 Year: ZOOS" Pit Set: X RELOCATION Previous Address: Proposed Use: r FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Tent: Valuation: Above/Underground Storage Tank Size: Paint Booth: Fireworks Display: Blasting: Date/Time: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Inspector: Address: Phone: Fax: City Phone: State Fax: Zip City State Zip SPECIAL INSPECTIONS ❑ BOLTING ❑ CONCRETE Firm Name: ❑ REINFORCEMENT Phone: Inspector(s): Fax: ❑ WELDING 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 inuree propert owner // Print Name �i[/j dtl�I f5(If Signature Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash ❑ Check ❑ Mastercard X VISA ❑ Other Bankcard #: Expires: VIN#: Authorized Signature: i 6..)1.. VAR LA-1V a 4cee.asZo -r s to/ J/ke 19309 O -i S400r.4a/k o 0 co 1 kfitl N tD n .sL mitki, .1_931Q_ 1 N U 1 1 PANNING DEPT. APPRO Br r o 3 A DA u6os7-14L /i