2003, 01-14 Permit App: 03000274 Relocate MHProject Number: 0300027-1 Inv I
Application
Date: 1/14/2003 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: RELOCATE SINGLE WIDE MANUFACTURED Contact: BRAN, JOSE
HOME Address: 8610 E HARRINGTON AVE
C - S - Z: SPOKANE, WA. 99202
Setbacks: Front Left: Right: Rear: Phone: (509) 879-0668
Group Name:
.Site Information: Project Name:
Plat Key: Name: District: H
Parcel Number. 45184.6005M
Block: Lot: 5
SiteAddress: 8610 E HARRINGTON AVE #5 Owner: Name BRAN, JOSE
Spokane, WA USA 99202 Address 8610 E HARRINGTON AVE
Location:. SPO SPOKANE, WA. 99202
Zoning: UR -7 Urban Residential -7
Water District: 999 UNKNOWN Hold: ❑
Arca: .011 Acres Width: 0 Depth: 0 Right Of Way (fl). tl
Nbr of Bldgs' 1 Nbr of Dwellings: 1
Review Infortnation:
Review
Site Plan Review
Released BY-
Plan
ti:
PI n Review
Special Reviews/L - /
t
Permits:
•
Released By: '
AlansJactured Honw
Contractor OWNER Firm' OWNER
Phone.
Item Descnntion
INSPECTION FEE
COUNTY SURCHARGE
Units Unit Desc
1 SECTIONS
1 Y OR BLANK
Operator JAS Printed By: JAS
Fcc Amount
$511.00
$11.00
Permit Total Fees: $61.00
Print Date' 1/14/2003
3
Project Number 03000274 Inv: 1
Application
Date: 1/14/2003 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
L & I SAFETY INSPECTION MUST BE CONDUCTED AND CORRECTIONS MADE, IF ANY,
PRIOR TO OCCUPANCY
Payment Summary:
Permit Type
Manufactured Horne
Fee Amount Invoice Amount Amount Paid Amount Owing
$61.00 $61.00 $0.00 $61.00
$61.00 $61.00
$0.00 $61.00
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 he true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
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: JAS Printed By: JAS
Print Date. 1/14/201)3
r
ILI
ANI
Spoiw' CouNp"
PROJECT APPLICATION WORK SHEET ' '\ •
• SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROAD\VAN' AVENUE N,
SPOKANE, WA 99260 t '
509-477-3675
SPECIFIC SITE INFORMATION
Street Address. a•-• 9916/6
Assessor's Tax Parcel N▪ umber(s):
Legal Description:
71671 k5 4e47sttj 4%/9' 97167
-41
S �
Project Description:
O Building Permit
hange in )Tse
O Grading
O Manufactured 1 -tome Permit
O Relocation
0 Sign
O "Tenant (New/Change)
0 Other
. Department Use.Only . ; "°..: _ `<
0 Applicant
# of shirks
bin m Ili'or>y P.
\\'atcrt)uct/Irunc,
.. - .. ..
Sewer Drstrat/Puntcvor•,,, ',
- -
Road width -
-
•
Setbacks
Front -:.Ree
/Lefr .'
-
: RIghe
,
r..
School Disrnct-
..
Fire District ,'•"
' /onuig
..
11cat source (elect nc, gas, etc)
OWNER/APPLICANT INFORMATION
Inr(tvle II hn ,lremll he nnl aed rsvmrtmr iter• tiv/a/
0 (1nt n, Phone: (\
\]se t a4-2 Fax 29
hailing
0 Applicant
# of shirks
bin m Ili'or>y P.
Phone
I:.a.
AJJrrs
.C)„,/
AWImg Addrrs
Finished basement sy ft.
Occupancy group
Construction Npe
Gib, st.r, ,6p
PP
1]n, State, Yip
11cat source (elect nc, gas, etc)
❑ 1
) d PL c`..49
=tont,
/" L
'
•
Phone
Fa'
Ati:75; 7,42
lathng address
�11 1 �I.nlrng Advt.:,❑Archerct/I
^5
t:tit stain/ip
fin, Stare 'Lap
\\ r\ state Cnntraernr hint- =
Conuu name
PROTECT INFORMATION
Building Information
Budding height to peak
# of shirks
bin m Ili'or>y P.
Unfinished b.ucmrnt sq. fl.
Dtmenswns
Tut al habitable space
°id Nun- ay ft
Finished basement sy ft.
Occupancy group
Construction Npe
Garage sq- ft
Deck sy ft.
Cost of project
11cat source (elect nc, gas, etc)
Manufactured Home
Non-Reidential Energy Code. Compliance?
Sign
\\'hat is the current use of this property?
width:
�' / /
•L//
Plan's I rammer
Length:
/
What is the square ft
facet �`
(age of the signI
low high is the sign'
Year
_—
de
Make-
1'
# of signs
In.pu for
Area of existing signs
r�a
O Welding
sr
O Reinforcement
Addtcs.
Relocation
Fire Safety •
Pro Ious address
Fire SpnnLli.r
Paint tax Fre:\larm
Tent
Fireworks display
Proposed use
Value
Special Inspection$ Regiired?
r ...
Non-Reidential Energy Code. Compliance?
Finn NamePhone
\\'hat is the current use of this property?
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes 0 No
\\'ill the site be scn'ed by a septic system? 0 Yes 0 No
Plan's I rammer
Phone
In.pertor.
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 304'0 on rhe property? (. 0 (r rise in 100 ft)
( /'%) O Yes No
Are critical or hazardous narenalsused or stored on site?
, O Yes-- 0 No
Addre..
In.pu for
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Addtcs.
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes O No
If yes, dentin, on sue plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
I f yes, ldentj, on Site plan 0 Yes 0 No
\\'hat is the current use of this property?
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes 0 No
\\'ill the site be scn'ed by a septic system? 0 Yes 0 No
Is any part of the property within a 100 yr flood plain?
/fj'ec idents on silt, plan
0 Maybe 0 Don't know- 0 Yes 0 No
Are or will there be wells located on the propert> ` -
I f j -es, !dentin, on the site plan 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the property?
If yes, identify on site p/em 0 Yes 0 No
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 304'0 on rhe property? (. 0 (r rise in 100 ft)
( /'%) O Yes No
Are critical or hazardous narenalsused or stored on site?
, O Yes-- 0 No
DEPARTMENT.USE ONLY
,Is the property in a designated Stormwater Control Area?
•.. . - O Yes
O No
Is public sewer available to the site? ' 0 Yes 0 No
-
Is the property inside the ASA?.
,. ..
- - 0 Yes
O Yes
0 No
O No
Is public water available to the site? • . 0 Yes . 0 No
,Is the property inside the PSSA?
. ..
0 Yes
.. -
0 No
Is the property located within 1000 feet of a Natural Resource Area?
O Yes O No
Date Received.
Staff Itepre,uvam e
METHOD OF PAYMENT
VISA
❑ (:ASI I ❑ CI B?CK ❑ ❑ .k> -`?I; ❑
DIICOVER
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
EXPIRES
BANKCA RI) NUMBIdt:
AU'1'I IORI%ED SIGNATURE
SURTO FAL
-TOTAL FEE
MIN/MUM PERMIT FEE ISSIS00PLEASE
Al \KE CI IRCKS PAVAIil.li 10 SPOKANE
COL'SIY PERMIT CENIFR