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2001, 06-12 Permit App: 01004569 MH
Project Number: 01004569 Inv: 1 App*cation Date: 6/12/01 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: PLACEMENT OF DOUBLE WIDE Contact: HOMEBOYS CONSTRUCTION Address: 14525 N NEWPORT HWY C-S-Z: MEAD,WA.99021 Setbacks:Front 30 Left: 26 Right: 6 Rear: 78 Phone: (509)468-1750 Group Name: Site Information: Project Name: Plat Key: 006047 Name: SP-1205-99 District: F Parcel Number: 45183.0664 Block: Lot: B SiteAddress: 503 N DICK RD Owner: Name: SMITH,LOWELL SPOKANE,WA USA 00000 Address: 503 N DICK RD Location::SPO SPOKANE,WA 99212-2860 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 12,413 Sq Ft Width: 80 Depth: 155 Right Of Way(ft): 40 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: -,,,/ .0„,, Department Review / , BUILDING Site Plan Review (Releasedr r , Al Bk Hold Reasons: Permit Conditions: _______y BUILDING Plan Review Releasedy. i _ ✓SAV i._' �Q ,`'f Hold Reasons: Permit Conditions: `I / I / f e. IP ENGINEER Approach/Drainage tI Released By: 4- ) a-b j 1 Hold Reasons: Permit Conditions: CALF/1/410c g3___ Permits: 60L'I rosy bkL 7° l SSS c:L JLf 2- Pi,A-tt' C,t Z-v I1 ,ti . Manufactured Home Contractor: HOMEBOYS Firm: HOMEBOYS Address: 14525 N NEWPORT HWY Phone: (509)468-1750 MEAD,WA 99021 Item Description Units Unit Desc Fee Amount INSPECTION FEE 2 SECTIONS $100.00 COUNTY SURCHARGE 1 Y OR BLANK $22.00 Permit Total Fees: $122.00 f Project Number: 01004569 Inv: 1 Application Date: 6/12/01 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summary: Operator: DMD Printed By: DMD Print Date: 6/12/01 Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Manufactured Home $122.00 $122.00 $0.00 $122.00 $122.00 $122.00 $0.00 $122.00 Notes: PROJECT APPLICATION i'lli SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT Aii 1026 WEST BROADWAY AVENUE SPOKANE,WA 99260 SPOIcANE COUIy1Y 509-477-3675 –0/— c / Project Description: A16.6,-) bo U &.)i,A Z < l ' 0 i 10, PO--o P TYPE OF APPLICATION ❑ Building Permit El Change in Use El Grading X Manufactured Home Permit ❑ Relocation El Sign ❑ Tenant (New/Change) ❑ Other SPECIFIC SITE INFORMATION StreetAddress: 5()3 /t J i /< Assessor's Tax Parcel Number(s): Legal Description: "" ,5--P --q9 - /'d-a$ der% ala Department Use Only Water District/Purveyor: Sewer District/Purveyor Road width Setbacks Front: Rear: School District: Fire District: Zoning Left: Right: OWNER/APPLICANT INFORMATION Cil Indicate who should be contacted regarding this project wner: ,., // Phoned V_ 77/ ' XApplicant: _ / Phone: /j 8—11-0) ❑ l I Fax: 7 7k/A DOC- yJst I/� Fax: i16 2 57 24 Mailing Address: Mailing Address: City,State,Zip City,State,Zip C/f 1 y itAw)u to--A 93 3)‘ El Co ractor c Phone (jf x--/ 7 S") CI Architect/Engineer Phone /1 - 4?0Y — Fax 462 ,472:4 Fax Mailitjg addre Mailing address 11-/-d- / gyp., i7. City,State Zip City,State Zip , yi-Le_,,4O ,9".2J WA Sta Contractor license# Contact name: / o f 6 o 3-3'Pe PROJECT INFORMATION Building Information Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft. Dimensions Total habitable space 2,d floor sq.ft. Finished basement sq.ft. Occupancy group Construction type Garage sq.ft. Deck sq.ft. Cost of project Heat source(electric,gas,etc.) Manufactured Home Sign- Width: - i ignWidth: / Vvs t t Length: 7m L 0 /i What is the square footage of the sign How high is the sign? face? Year: Make: #of signs Area of existing signs .J00 0 Relocation Fire Safety Previous address Fire Sprinkler Tent Paint booth_ Fire Alarm _ Fireworks display Proposed use Value Special Inspections Required? Non-Residential Energy Code Compliance? Firm Name Phone Plans Examiner Phone Inspectors: Address Inspector Phone O Concrete 0 Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? O Yes KNo What is the current property size? If yes,identify on site plan (square feet or acres) /2, '/ Is any part of the property within 250 feet of a shoreline? What is the current use of this property? •��S 1�, If yes,identify on site plan O Yes 1 10 Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes KNo 0 Don't know O Yes No Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property? If yes,identify on site plan If yes,identify on the site plan 0 Yes f io 0 Maybe O Don't know 0 Yes t4No Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the propert property? 0 Yes No Ifyes,identify on site plan 0 Yes IkNo Are there slopes greater than 30%on the property?(3 ft rise in 100 ft) Are critical or hazardous materials used or stored on si e? ( ....„..---%) O Yes No 0 Yes No DEPARTMENT USE ONLY 7 Is the property in a designated Stormwater Control Area? Is public sewer available to the site? Yes O No O Yes O No Is the property inside the ASA? O Yes O No - Is public water available to the site? Yes O No OYes 0 N Is the property inside the PSSA? O Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? 0 Yes 0 No i---. Date Received: Staff Representat'ye: / / foi Department of Labor&Industries ALTERATION PERMIT Factory Assembled Structures Section y ' ;; Do not complete shaded areas INSTRUCTIONS: +J.4,..)1/ °`� (-Permit# -- � 1. Com Complete all spaces,includingthe signature box(marked with an X). p p g Invoice# 2. Draw a map on reverse side of WHITE iopy only. 3. Forward completed permit and fees to the nearest L&l office. See list on reverse. 4. Contact and schedule the inspection with the same L&l office within 15 days. Insignia# J Owner last name first name Day time phone % Date / r,' '� C ` '..__' . ( ) c/o - -.7 (-1 I ( �i '( 0 I Address City State ZIP / / ,` J / 0 l j A---,(- / .(( -R--,. .� C` -7 C.. C_:/-i,; r-4 eS --/ Z 1 14 <"-l cC.2 LI Installer/Contractor/Dealer Phone Contractor's registration number f /. rt.' l 4 0 `/ )- ( ) 6 t5; 1 1 c_) � 6/o/t/t Z ' ' C.' �r_. Address City State ZIP+4 V i q S) . . A/L. I?, - / / }`/ . / '/r ,47s) `._) 7 '----: /, Z Check the appropriate boxes in section A and section B. FEES A (.1Commercial Coach B ❑ Alteration Inspection(check appropriate boxes below) $ 1.1 Air Conditioning/Heat Pump Serial No. Electrical �y Electrical Appliances 4:.1 Mobile Home Fire Safety Serial No. Gas Furnace - Gas Piping HUD No. Plumbing Structural Serial No. Recreational Vehicle or ❑ Park Trailer Wood/Pellet Stove — — Serial No. Plan Review $ RV Inspection $ Model No.or Plan Approval No. Original Permit Reinspection No. $ Technical Inspection $ Note: This permit expires one year after date of purchase. (Non-refundable) (-Signature of applicant or authorized representative Make check payable to: Dept.of Labor&Industries , J FEES DUE $ - Department use only -� U1 Request approved or L] Request denied because of specific violations of Washington rules and regulations. Violations must be 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 lease any non-complying mobile home,commercial coach or recreational vehicle. PO°*\O � `G�1O� LL 324-2640 FOR INSPECTION SEP SP1 CA PLEASE LEAVE NAME & AcGO C)\10, ALTERATION PERMIT NUMBER Included are forms required which must be completed and fees submitted before reinspection. C Date Area office Inspector /Total pages 1 F622-012-000 alteration permit 8-99 White-Olympia Canary-Inspector Green-Contractor Pink-Purchaser Goldenrod-Purchaser /i ( i 48 i�L .51r3 ,: B, This site plan is being su•mitted for thepurpo��of N• , obtaining a building per it and is a true and correct representation of the •.. AU known property , 78.5 l lines/dimensions, .ki 1' es.structures and easements have been identified.- , -.•' ated are wetlands, i sia bodies of at-r s -iii:,res' ., er critical areas. 1 Date: ��_ N.). I ,bc-. i ADDRESS i -- .-..L_ ZONE �'ilk ROAD WIDTH ri ;� Fa' ,l rRa1'oSE.D i 1 $•19 FRONT 6 8 •� RSM WED ::Y `%« ' ' � M�F J 4 1 04 0 . �� s l I 3 k �, 13o' I 3 sig --7 ..r---. -- _ I' c44 'F©L04Elk