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2013, 06-23 Permit App: FAS-2013-0007 MHSpokane Valley - Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 permitcenterPsooka nevalleY.orq (Staff Use Only) PERMIT NUMBER: PERMIT FEE: MANUFACTURED HOME PERMIT APPLICATION 111 OTHER SITE ADDRESS: ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: -AA)A- ADDRESS: ),710/ ^%. 6]/ e-Z-11Rd CITY: PHONE: k4.._ ,'q- 954- -7557 CONTACT NAME: STATE: (/q ZIP: 1loi( FAX: CELL: PHONE: FAX: CELL: CONTRACTOR NAME: \ft,Lh9vt 5072-- MAILING ADDRESS: 'Po 60y ) 330 CITY:� �CLlio-- STATE: .L) ZIP: •R'- C3gSg PHON . 755 FAX: CELL: CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOP/E OF WORK IN DETAI AND INDICATE U E: i. 06 LI iii -04-1- 'IL ,..70 4 4,10.44...6,,,,F..."/„.o e_.,/,_,,, -.1/4,4„2„„J- l_j1Z t df..4AC,e MANUFACTURED HOME WIDTH: 01(0 MANUFACTURED HOME LENGTH: 4 q ' 41" YEAR OF MANUFACTURED HOME: o.O%/ PIT SET: ,/ SEPTIC/SEWER: / MANUFACTURER: ./gd,"Plve_ PREVIOUS ADDRESS: p to -Z ock 4,525- 6 . . . e- Lip c 902/ a_ PROPOSED USE:ce__ DISCLAIMER --Zo13-0007 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 submi ed and subsequently approved before this application can be processed. Signature, /' 1 Date: -7(3 Updated 1-11-11 Page 1 of 1 http://www. spokanevalley.org/filestorage/124/938/210/948/1496/Manufactured_Home_Permit_1-11-11.doc