1995, 10-05 Permit App: 95008118 MH TemporaryPROJECT NUMBER= 95008118 APPLICATNON 4 DATE= 10/05/95 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 304 S LONG RD
ADDRESS= GREENACRES WA 99016
PERMIT USE= DOUBLE WIDE MOBILE HOME Cif 0b2A4a-�-� C04,0"� >
PARCEL#= 55192.0320
PLAT#= 000501 PLAT NAME= CORBIN ADD TO GREENACRES
BLOCK= 25 LOT= 10 ZONE= UR -3.5 DIST#= G
AREA= F/A= WIDTH= 100 DEPTH= 380 R/W= 40
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= FISCHER, WILLMAR
STREET= 304 S LONG RD
ADDRESS= GREENACRES WA 99016
PHONE= 509 924 2199
CONTACT NAME= CHUCK GROOM PHONE NUMBER= 509 244 9992
BUILDING SETBACKS: FRONT= 35 LEFT= 15 RIGHT= 25+ REAR= 25+
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING SETBACK REVIEW REQUIRED O 4 VICVIC - C, `1 c5
' mw\rtne at-t.A W € 4L& i 'K- -Cm. y r*k- _ RVA.5r4.0 -AA_ ReavAtzireD
oce4447% >-rum"- ntEcu00,34 P. (l4 Cr
ENGINEER APPROACH/ DRAINAGE/ FLOOD ,015 ._ /b/Wqr
COMMENTS.
COMMENTS:
PLANNING UNPLATTED/SEGREGATED PROPERTY
COMMENTS:
/-C--4? S
UTILITIESW/IN PRIORITY SEWER AREA ��'Le.Jb� / .
COMMENTS:
o =1/-9S
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER PHONE=
YR/MAKE= 1995 OAK GROVE MODEL=
SERIAL#= WIDTH= 26 LENGTH= 56 HEIGHT= 10
PROJECT NUMBER= 95008118 APPLICATION DATE= 10/05/95 PAGE= 02
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 20.00
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 124.50 .00 124.50
124.50
.00 124.50
*******************************************************************************
* PROJECT NOTE: TOPIC = CONDITIONS DEPT = BUILDING *
*******************************************************************************
NO OCCUPANCY OF MOBILE HOME MAY TAKE PLACE PRIOR TO ISSUANCE
OF A SEWER PERMIT FOR THIS SITE.
PROCESSED BY: CAROL FRAZIER
PRINTED BY: CAROL FRAZIER
******************************** THANK YOU ************************************
APPLICATION INFORMATION
ASSESSOR'S tax parcel number?
at is a JOB SITE address?
-.;;:k
.G,3
Legal description as it appears on the property deed
rOi- '✓ R%�i.;' X/.iv 4l /C /2-1 N /40 ` of .��G / a t .2/G
OWNER or OCCUPANT
Mailing address
(2/4 .� / �j
ho I we contact r ardin
Phone
City, state
Zip
Who s uregarding this project?
Kr lat 4 Z'f'crc
4/7
Phone
What work is being done under this permit?
pry
o-7/ 7 L�_5-- 4
Contractor
Building height
dimensions
# of stories
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd floor area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
Manufactured Home
Sign
Width:
Year:
Length:
/0
Make:
FJ' ez-(c
What is the square footage of
the sign face?
How high is the sign?
Install
C
Wa State Cont actor license #
Contractor
Wa State Contractor license #
Mailing address
Mailing address
Relocation
Fire Safety
............:...................
Previous address
Fire Sprinkler _
Paint booth Fire Alarm
Tent
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
Contents of tank(s)
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
Wa State Contractor license*
WA State Contractor license #
Mailing address
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
N
Y
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NOTICE
The revie by the various departments as provided for herein is solely for the purpose of advising the Spokane County Health
District of the subject property's compliance with various codes and regulations. The issuance of a permit by the Spokane County Health
District for the installation of an on-site sewage disposal system is not to be construed as a vesting of a right by the owner /
representative to obtain a building_permit for this property. At the time that a building permit is applied for the subject property must
comply with all applicable federal, state or local laws, ordinances or regulations with the exception of those relating to the issuance of a
permit for the on-site sewage disposal system by the Spokane County Health District, pursuant to this form. Accordingly, although as of
the date of this document the subject property may meet certain state or local laws, ordinances or regulations, in the event such items
change between the date of this document and application for a building permit, the owner / representative will be responsible for
meeting such regulations in effect on the date of the application for the buildingnnit.
Street Address: ---
Parcel Number:
Legal Description:
Property Owner: l l J 1
Mailing Address: d-1 0
F
Phone:
0 Re
Signature: Date:
PLANNING DEPARTMENT
Reviewed by:
dedicatory language within plat 4611
.../Subject property is legally divided _
Certificate of exemption required GC 3' - 9 S
✓ Use authorized under the Zoning Code
Setbacks meet Zoning Codes requirements
A4'A-Shorelines permit required
W,4Variance required for the following reason:
Other:
Date: L/3 ! `4
DIVISION OF EN INEERING
0 Site drainage review required
C 4aintained county road
Approach permit required ‘,...6/
bFlood zone
Variance requirements
Other :
Reviewed b�� �, 1. J i! ���>I Date:
DIVISION OF BUILDINGS
TRANSACTION #: M-1333
The Division of Buildings has advised the property owner / representative that an in depth review may be necessary when a formal
building permit application is submitted.
Reviewed by:
Date:
co"I
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