2005, 09-28 Permit App: 05003542 MHProject Number: 05003542 Inv: I Application Date: 09/28/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Parcel Number: 55083.9601 Block:
SiteAddress: 1622 N HODGES LN
Location:: CSV
Zoning: UR -7 Urban Residential -7
Water District:
Area: 0 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Lot:
Owner: Name: MYRON INGABULL
Address: 1622 N HODGES
SPOKANE VALLEY, WA 99037
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review Information:
Review
Site Plan Review
Originally Released: 09/28/2005 By: CBATES
Plan Review
N/A -PER MANUFACTURES SPECS
Originally Released:
Sewer Review
09/28/2005 By: CJJANSSE
Released By:
Originally Released: 09/28/2005 By: CJJANSSE
Permits•, .: ,. ..:uo,.:Nffi
Operator: CJJ Printed By: CJJ Print Date: 09/28/2005
Project Number: 05003542 Inv: I Application Date: 09/28/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
- - Manufactured Home
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
Item Description Units Unit Desc Fee Amount
INSPECTION FEE 2 SECTIONS $100.00
Permit Total Fees: $100.00
Notes: r
ALL PERMIT APPLICATIONS IN MISSION MEADOWS MHP MUST HAVE PLANNING
DIVISION REVIEW BY MICKI HARNOIS OR GREG MCCORRMICK
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Manufactured Home $100.00 $100.00 $0.00 $100.00
$100.00 $100.00 $0.00 $100.00
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 be
complied with. Subsequent issuance of a permit shall not be construed to be 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: CJJ Printed By: CJJ Print Date: 09/28/2005
Spokane
./O Valley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-`W11r,
www.s okanevalle .or o
Manufactured Home
Permit Application <;
SITE ADDRESS /& 7,
ASSESSORS PARCEL NO: .�D63, q�6L LEGAL DESCRIPTION: Z,,)l� �iS.S'Uh iajt���
Contact Person'
Name:
Phone: - Z
Describe the scope of work in detail: /
MANUFACTURED HOME
Width: '2!&�--0 �� Length: &o �-o �` Year: ZUUS Pit Set: Yes
Manufacture:
Previous Address:
Proposed Use:
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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
Signature � :;r� / � G6l�_ Date
Method of Payment. (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005
SPOKANE COUNTY UTILITIES/SEWER & GFC
1026 W. BROADWAY, SPOKANE, WA 99260
(509)477-3604
Received From _
Site Address
Account Numberi
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