2004, 03-26 Permit App: BLD-04-03920 MHSpiokane
.0,00Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
MANUFACTURED HOME
Job Address: 514 N HODGES RD
GREENACES WA 99016
Description: SINGLE WIDE MANUFACTURED HOME SINCE 1989
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
Lot:
RUEGSEGGER, JASON S & CHRISTEA
WALDON, SCHWEDA & MONTGOMERY
2206 N PINES RD
SPOKANE, WA 99206-4721; I
Blk:
Phone:
Phon
Lic No:
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Application #: BLD -04-03920
App d:
Issued:
Expires:
Zoning:
03/26/2004
09/22/2004
General Information:
SECTIONS
YEAR BUILT
DIMENSFQNS
# OF STOIES
FRONT SE` BACK
REAR SET: ' CK
LEFT SETBA K
MANUFACTU'ER
1w
1989
14 X
LETTE
Fees:
PER SECT!
ON FEE
CITY OF SPOKANE VALLEY
APPROVED FOR SUBMITTAL
Initials / Date
Building .I `t1 t7( --m
Total Calculated:
Deposits/Receipts:
Total Due:
50.00
50.00
0.00
50.00
THIS IS NOT A RECEIPT
Sii'�1ne
jUalley
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:
$f'i k'. b6 J5 e/J 14101.
Assessor's Tax Parcel Number(s):
Legal Description: n(� /�
PERMIT DESCRIPTION: �?� �-� la.. ma h (Ac - c4 ct v ,PJ �^-
-0IA�-A- w S 4.oc).
l
❑ Building Permit ❑ Change in Use ❑ GradingManufactured Home
❑ Relocation E Tenant Improvement ❑ Fire Safety Other
OWNER/APPLICANT INFORMATION
n
Ownera1/4$0 YU kV. S--9( q,cr---
Phone: 92$- lay I x. v CJ
❑ Applicant: LU&11cOu / ,vwki440-(5-
Phone: t ac(- 76. 66 Fax:
Address: 57c7 A( /704:e7-, Address: ». a / .-,eii,
7 v PQtoGcv-e,-i W F'961(. c oc._rz v"tt-ey W,4 g't 4
City State Zip Code Ci / State Zip Code
❑ Contractor:
Phone: Fax:
Address:
City
State Zip Code
WA State Contractor License #:
❑ Architect:
Phone: Fax:
Address:
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"" 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:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?
MANUFACTURED HOME
Width: (y 1
Manufacturer:
Length: 66 ' Year: /7 O S Pit Set:
RELOCATION
Previous Address: /f/4
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation:
Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
State
Zip
❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
E 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 inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature: