1995, 11-08 Permit App: 95009375 MHPROJECT NUMBER= 95009375 APPLICATION, DATE= 11/08/95 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 18820 E JACKSON DR PARCEL#= 55082.0916
ADDRESS= OTIS ORCHARDS WA 99027
PERMIT USE= NEW DOUBLE WIDE MANUFACTURED HOME
PLATS= 000146 PLAT NAME= BARKER -ROAD MOBILE HOMES 1ST A
BLOCK= 8 LOT= 16 ZONE= UR -7 DIST#= G
AREA= 00000000 F/A= F WIDTH= 70 DEPTH= 160 R/W= 50
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= HALLOWELL, DOROTHY
STREET= P.O. BOX 1023
ADDRESS= VERADALE WA 99037
CONTACT NAME=
PHONE= 509 534 6062
PHONE NUMBER=
BUILDING SETBACKS: FRONT= 50 LEFT= 20 RIGHT= 70 REAR= 15
****************************** REVIEW INFORMATION ***+*************************
DEPARTMENT
REVIEW REQUIREMENT
BUILDING SETBACK.REVIEW RQUIRED
COMMENTS: 5 \TC
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HEALTHDIST TeVERAGE
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/**
COMMENT
CONTRACTOR= OWNER
YR/MAKE= 95/GUERDON
SERIAL#=
ITEM DESCRIPTION
MOBILE HOME PERMIT *****************************
PHONE=
MODEL=
WIDTH= 28 LENGTH= 50 HEIGHT= 10
QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 21.00
PERMIT TYPE FEE AMOUNT, AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 125.50 .00 125.50
125.50
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: BURRIS, ROBIN
.00 125.50
PROJECT NUMBER= 95009375 APPLICATION DATE= 11/08/95 PAGE= 02
******************************** THANK YOU ************************************
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APPLICATION INFORMATION
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'What is the JOB SITE address? ASSESSOR'S tax parcel number?
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Legal description as it appears on the roperty deed
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Phone
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What work i5 being done under this permit?
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for district
Property.sae
Right of way width - -.
Water district .r
Building
Building height
# of stories
Contractor
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd floor area
Finished basement area
ArchitecVEngineer
Garage area
Size of decks, etc.
What is the heat source?
What is the coat of your project?
Manufactured Home- :.:
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Width:
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Length:
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How high is the sign?
Year:
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Installer
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Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Relocation. _---: --
Fire Safety -
Previous address
Fire Sprinkler Tent
_
Paint booth _ Fire Alarm _ Fireworks display
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address_ _
Mailing address
Fuel Storage Tanks ;-.
Swimming Pool ' .
(Circle one) Above -ground Underground
Size / gallons
Private
Contents of tank(s) Sae / gallons
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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