1999, 10-25 Permit App: 99007819 Relocate MHProject Number: 99007819 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: RELOCATION OF SINGLE WIDE
MANUFACTURED HOME
Setbacks: Front 25 Left: 25 Right: 50+ Rear: 20+
Date: 10/25/19 Page 1 of 2
Site Information:
Plat Key: 000700 Name: EASTWOOD ADD.
Contact: WILLIAMS, DEL
Address: 615 S HOWE
C - S - Z SPOKANE, WA 99212
Phone: (509) 448-1247
District:
Parcel Number: 35231.1146
SiteAddress: 615 S HOWE ST
SPOKANE, WA 99212
Location:: SPO
Zoning: UR -3.5 Urban Residential 3.5
\Vater District: 999 UNKNOWN
Area: 0 Sq Ft Width 70 Depth: 260 Right Of Way (ft). 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Owner: Name: WILLIAMS, DEL
Address: 6222 E NIXON AVE
SPOKANE, WA 99212
Hold: ❑
Department Review
BUILDING Site Plan Review
Comments:
BUILDING Plan Review
Comments:
HEALTHDISTRICT Septic System R
Comments:
BUILDING
Comments:
Permits:
Special Reviews
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
STATE SURCHARGE
INSPECTION FEE
COUNTY SURCHARGE
Manufactured Horne
Finn: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 Y OR BLANK
1 SECTIONS
-I:
1 Y OR BLANK
Fee Amount
$4.50
$50.00
$11.00
Permit Total Fees: $65.50
Department of Labor & Industries
Factory Assembled Structures Section
INSTRUCTIONS:
1. Complete all spaces, including the signature box (marked with an X).
2. Draw a map on reverse side of WHITE copy only.
3. Forward completed permit and fees to the nearest L&I office. See list on reverse.
4. Contact and schedule the inspection with the same L&I office within 15 days.
ALTERATION PERMIT
Do not complete shaded areas
r Permit M
123699
Invoice
Insignia
Owner last name
first name
Day time phone
Date
Address City
State ZIP
I nsialler/Contractor/Ikaler
Phone
( )
Contractors registration number
Address
City State ZIP+4
Check the appropriate boxes in section A and section B.
Commercial Coach FEES
A B Alteration Inspection (check appropriate boxes below) $
Air Conditioning/Heat Pump
Electrical
Electrical Appliances- i'i,i
'ire Safety ti�:PhBris':EliTO LABGFBIf•!DI!STRIcS
Serial No.
fi Mobile Home
Serial No.
HUD No.
ulRecreational Vehicle or Eji Park Trailer
Serial No.
Model No. or Plan Approval No:
Note: This permit expires one year after date
("Signature of applicant or authorized representative
A._X 1 1
• Gas Furnace
Gas Piping
Plumbing
Structural
Wood/Pellet Stove — -
Plan Review
RV Inspection
Reinspection
Technical Inspection
OCT 2 5 1999
Scrial No. nEf�l��i(o v-G�I-I` ..
821.1.e11.t' i:, J"1Li,— _ $
$
$
Ongmal Penn
of purchase. (Non-refundable)
Make check payable to: Dept. of Labor & Industries
FEES DUE $ c 1,/-2%
Department use only
Request approved or ..'j Request denied because of specific violations of Washington,rules'and regulations. Violations must
•
0e corrected and reinspection' requested within 10 days for. recreational vehicles and 20 days for mobile homes and commercial coaches
•
'of the notice of violation date. (This does not apply to technical inspections):.It-Is unlawful to offer for sale, rent, or (ease any
non -complying mobile home, commercial coach or recreational vehicle.
ALTERATION PERMIT
CALL 324-2568 FOR INSPECTION
PLS GIVE PERMIT NUMBER
Included are forms required whicli.must be completed artd'fces submittedbcfore reinspection.
P622-012-000 alteration permit 10 9a
White -Olympia Canary -Inspector
foul pages
Green -Contractor Pink -Purchaser Goldenrod -Purchaser
-2
Site Plan
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