1993, 11-09 Permit App: 93010893 MHPROJECT NUMBER= 93010893 •APPLTCATI6N DATE= 11/09/93 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 18914 E MARIETTA AVE PARCEL#= 55082.0502
ADDRESS= OTIS ORCHARDS WA 99027
PERMIT USE= DOUBLE WIDE MOBILE HOME
PLAT#= 000000 PLAT NAME= UNKNOWN
BLOCK= LOT= ZONE= UR -7 DIST#= G
AREA= 00000000 F/A= F WIDTH= 70 DEPTH= 117 R/W=
# OF BLDGS= 2 # DWELLINGS= 10 WATER DIST =
OWNER= HASTIE, EVLA
STREET= 18914 E MARIETTA AVE
ADDRESS= OTIS ORCHARDS WA 99027
PHONE= 509 927 3924
CONTACT NAME= ELVA HASTIE PHONE NUMBER= 509 927 3924
BUILDING SETBACKS: FRONT= 29 LEFT= 24 RIGHT= 32 REAR= 26
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING SETBACK REVIEW REQUIRED
COMMENTS:
c9K Re?e stk.)
F4-et-NcatAni6
ENGINEER FLOOD PLAIN OR DRAINAGE AREA
COMMENTS:
HEALTHDIST NEW OR ADDITIONAL WASTE WATER
COMMENTS:
11ZyAfc.H 4_
II- 8-9_.9
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER PHONE=
YR/MAKE= 86/GOLDEN STATE MODEL=
SERIAL#= WIDTH= 26 LENGTH= 52 HEIGHT= 10
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 18.00
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
PROJECT NUMBER= 93010893 APPLICATION DATE= 11/09/93 PAGE= 02
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 122.50 .00 122.50
122.50
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: BURRIS, ROBIN
.00 122.50
******************************** THANK YOU ************************************
APPLICATION WORKSHEET
L General Information
Contractor information
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Parcel number
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Phone
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Main floor
Dwelling units
Occupant load
Legal Description
Stones
Cntical Material
Building dimensions
Total square footage
Req'd parking
Handaap parking
Buildings
Property size
Water District
Mailing address
Num berol:
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Building Information
Project Information
Addition
Remodel
Change of use 1
Square footage breakdown
Main floor
Dwelling units
Occupant load
Budding height
Stones
Cntical Material
Building dimensions
Total square footage
Req'd parking
Handaap parking
Sprinkler system
Mailing address
Mailing address
Square footage breakdown
Main floor
Uncovered /covered deck
Second floor
Other
Finished basement
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Unfinished basement
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Garage
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Healin, and insulation information R—values
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Budding contractor
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Phone
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PROJECT CONTACC
PI IONE
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
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Budding contractor
Plumbing contractor
License number
Phone
License number
Phone
Mailing address
Mailing address
Gly, sa te, zip
City, state, zip
Heating contractor
Other/Lender
Phone
License number
Phone
License number
Mailing address
Mailing address
City, sale. zip
City, stn te, zip
PROJECT CONTACC
PI IONE
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
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TY HEALTH DEPARTMENT
OEGER,M.D.,M.P.H.
Health Officer
Division of Sanitati
N. 810 Jefferson St eet
Spokane, Washingto 99201
I Name
APPLICATION FOR PERMIT TO
NSTAL
Address of Proposed
Type of Use
Number of Be
Water Suppl
Septic tank capacity
DAT
No 405719
RECONSTRUCT SEWAGE DISPOSAL FACILITIES
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well, garage and other outs buildineptic gs
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planned?
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ther
other importantMake note
of any heavy slope or topographic
hic swampy area
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i'ks :
RACTOR
46 REV./4E41T„
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For Spokane County Health
Department
:177..777-