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2002, 11-08 Permit App: 02010025 MHProject Number 02010025 Inv 1 Application Dale: 11/8/2002 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Protect Information: Permit Use: DOUBLEWIDE MANUFACTURED HOME EXISTING SINCE 1971 Setbacks Front 311 Left: 34 Right' 10 Rear: 25 Site Information: Plat Key: 111111762 Name: FAIR ACRES 11'TOBILE HOME ADD District H Contact: TREBILCOCK, KENNETH Address: 1446 WRIGHT C - S -Z: RATH DRUM, ID 83858 Phone: (5119) 994-5737 Group Name. Project Nantc: Parcel Number: 451191.211113 Block Lot: SiteAddress. 11518 E JACKSON AVE Owner Name: TREBILCOCK, KENNETH SPOKANE, WA USA 1111111111 Address: 1446 WRIGHT Location:: SPO RATH DRUM, ID 83858 Zoning: UR -22 Urban Residential -22 Miter 1)istrict Area. 8,11511 Sq Ft Width: 70 Nbr of Bldgs' 1 Nbr of Dwellings: 1 Review Information: Hold ❑ Depth: 115 Right Of Way (ft): 50 Review Released • 41.4111,n Plan Revie)y1/4 Rel ascd By if Ar Approach / Drainage Releascdi By ll -$=oma Septic System Review Sort o sues„ e,,,:r.1 >foz _Z%6edrooms only. Permits: Released Bp:. Operator: DMD Printed By: DMD Print Date: 11/8/21)112 ' Project Number: 02010025 Inv. 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/8/2002 Page 2 of 2 Manufirctured Homc Contractor. OWNER Firm: OWNER Phone: Item Description INSPECTION FEE COUNTY SURCHARGE Notes: Units Unit Desc 2 SECTIONS I Y OR BLANK Fee Amount $I0O 00 $22.00 Permit Total Fees: $122.00 Payment Summary: .. , , Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Manufactured Home $122.00 $122.00 $122.00 $122.00 $0.00 $122.00 $0.00 $122.00 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 w ark will he 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: DMD Printed By: DMD Print Date: 11/8/2002 09/23/2002 10:26 FAX 509 477 4464 SPOKANE CO BLDG. fQ 002 I�I u _ SPOKANT COUNTY PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE,0A 9-47736759260 Ori — OD‘ SPECIFIC SITE INFORMATION Street Address: //S/g F s6N y,,Lvl tAe. ��� / �fri 99zo& Assessors Tax Parcel Number(s): col 200 5 �q / / ' / • - ' ' L, Legal Description: L 3 ✓ g / Fa; racreg Map/(L /v4t Ez Project Description: rfi.)(`-4451-11/1- tI M ! q 1 'Building Permit O Change in Use O Grading 0 Manufactured Home Permit 0 Relocation O Sign O Tenant (New/Change) 'k7 Other Re`Mazot rI - Departmerit,Use',Oiily : Water District/Purveyor Sewer D6'nct/I'untyor Road width Setbacks : ih.i,- ''11oaf,' itear School Distort Hee District: Zoning 'Left: " ; ]tight:. . OWNER/APPLICANT INFORMATION 0 Lnhurte ubnabOEM be mn/dBed n•gsrrrLng!lilt �ror• Prow"— ikon: 4 c/_ S237/ `/9'{- Vee to e tin T✓ bi 1e.tx tat-- Fax: O7?5 Ai Applicant: Phone l'ar Mailing Addis"': 1 446 1/01(19 kf Mailing AJdrecs Dimensions CR Stam, %p 20 n tfridnith gsy 6n. State, Zip 1t ❑ Cnmr clot Thum Fax 0 Amlutcct/lintanccr ]'hone Fax Mailing addnna hlnd„ig addros Ilea' source Weenie, gas, etc.) City, Stam Zip Girt, Sime Zip WA Slate Contractor licence # (.nota„ „nine: PROJECT INFORMATION Building Information Building knight to peal: N of stories ;qui flour eq. ft Unfimshcd basement sy ft. Dimensions 'Total habitable space 211'1 fluor sy. fi 1t Occupancy group Construction type Garage sq It e '-0. 8 2002 Wet - 11'V r Cost of project Ilea' source Weenie, gas, etc.) 09/23/2002 MON 11:18 (T%/RX NO 65571 IJ002 quc,VER- 09/23/2002 10:26 FAX 509 477 4464 SPOKANE CO BLDG. • 1003 Manufactured Home a4x Le O Fire Safety - Sign Width: Phone �1 I 1.cngth: Paint booth _ Fire Alarm _ What is the square footage of the sign face? l low high is the sign? Year. 1 94 ` Value Alalic: 1/r s 414 Vi & 1-1-1.41C # of signs Atte of existing signs 0 C.0ICCtc 0 Wedding 2 — Address Relocation. Fire Safety - Firm Name Previous address Phone 1'ircSpnnklcr _ Tent Paint booth _ Fire Alarm _ _ Fireworks display Is there evidence of fill or excavation on the property? 0 Ycs I No _ Proposed use Value Spedal .Inspections Required? Non -Residential Energy Cod'e..Coinpliance?: Firm Name What is the current use of this property? •�7 li oS teCLG..F"t rv.-C. Phone Plans Examiner Phone:, Inspectors. Are there any wetlands, streams or ponds within 200 feet of the property? If yes, idennfy on silo plan 0 Ycs rNo Is there evidence of fill or excavation on the property? 0 Ycs I No Address Arc critical or hazardous materials used or stored on site? 0 Yes )0 No Inspector Phone 0 C.0ICCtc 0 Wedding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE Are there structures on the property? Ycs 0 No If yes, ideuhfy on site p/mi What is the current property size? (squate feet or acres) Is any part of the property within 250 feet of a shot •lint? If yms, den* on sae pine O Ycs No What is the current use of this property? •�7 li oS teCLG..F"t rv.-C. Is your property in a designated wildlife habitat arca?Will 0 Dont know 0 Yes fi No the site be served by a septic system? 0 Yes 0 No Is any part of the property within a 100 yr flood plain? lbw, identify an site plan ❑ Maybe ywDon't know 0 Ycs 0 No Are or will there be wells located on the property? Ifn, identffr on the shop/an 0 Yes 0 No Are there any wetlands, streams or ponds within 200 feet of the property? If yes, idennfy on silo plan 0 Ycs rNo Is there evidence of fill or excavation on the property? 0 Ycs I No Arc there slopes greater than 30% on the property (30 ft rise in 100 ft) [-/GA) 0 Yes cr(No Arc critical or hazardous materials used or stored on site? 0 Yes )0 No DEPARTMENT USE ONL Is the property in a designated Stormwater Control Arca? - . - - , Is public sewer available fo the site?: '. : O. Ycs , 0 No - .- .. , - . .• .. Is rhe property inside the ASA? O Yes 0 No O Ycs O No Is public water available to the site? ,: +.'i , . 0 Yes O No Is the property inside the PSSA? .10 Ycs 0 No - Is the property located within 1000 feet of a Natural Resource Arca? Date Reecho' Staff Representative: METHOD OF PAYMENT VISA 0 CASH 0 CHECK 0'1 ❑ , 0 FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DADS: i-XPIRI•:s. 13.\NKC,\Iib NUMIU•ai- ALill IOAIZI!D siGN.\'I'U1IF.: SUIYI'OT,U. „_ TOTAL FEE /)2L,,--- MINIMUM PERMIT nil? IS $35.0tlPl.l'_9SP: MAK (:I IIICKS PAYA113.1,.10 SPOKANE , COUN I Y !Itit,W'I' C1N1Ht 09/23/2002 MON 11:18 [TX/RX NO 65571 fj003 vvlio.[.vvl. iv.YJ 1n.a UVJ YII YIVV 09/10/2002 15:13 5093241567 or Un/Nr. 1,U nr.uU. SRHD EHS ADDRESS ZONE L-1 2 7 Cw UU.) PAGE 02 ROAD WIDTH FRONTRC. FLAN G COMMENTS aS -,_____- REVIEWED BY This site _Inn ic3ieing submitted for thepurpose of obtaining a :)ung perm( and Is a true and correct representation cif the proposal. All known property lines/dimensions, curb lines. structures and easements have been Iden ied. Aso indicated are wetlands, bo 'es of water, steep sicre'or Signe Date: 7; ell ,/toG/ 4 i 4r /v/e ,% v .