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 .