2007, 08-08 Permit: 07001884 InspectCITY OF
S okane
Valley
t
+_ 1
MANUFACTURED HOME INSPECTION RECORD CARD
PERMIT#: 0100
OWNER: Vykrj17Q
ADDRESS: \C -A n \ \ ,,T- (V 1G"Y°l 0 -a
MANUFACTURER 01)QX1OjMANUF DATE! �gLj'6
MODEL: SERIAL NUMBER: ,
t "HUD:' LABEL/STATE LABEL NUMBER: t,e! DATA PLATE:
DEALER: DEALER#:
ELECTRICAL -L& I FINAL APPROVAL:,
INSTALLER: 1=TC3 • K \Z isoLa t -ib,. WAYNES#: t J k til 1 11-0
�NSTALLER:, WAYNES#:
INSTALLER: WAYNES#: "a('o `/✓
INSTALLER:
INSTALLATION ;. S 41i. • c''`" " '
INSTALLATION#: ,_,r, IANCHOR#:, „)f/'a• "L4( ,J
c
INSTRUCTIONS U5 MANUFACTURER: ;•.. STATE:. / /
WAYNES#:, _
NFPA 225
FOUNDATION: FOUNDATION TO LOCAL BLDG CODE:
SUPPORT: SUPPORT LOCATIONS PER MANUFACTURER OR ENGINEERED DESIGN:
ELEVATION: ELEVATION OF LOWEST FLOOR(IF IN A, FLOOD HAZARD AREA):
- SUPPORT FOOTINITYPE c coo 'Ye:, I,: .c 0,t4'_,7 `. ° •
__ :SIZE:- : '_= "7.1;.-": __ar-,1u+7_ -"IS-:-.4>c,44-5L
:"-L> -.`1-'�i_
/PIERS MATERIAL _'•
ANCHORS:
SPACING:
SHIMS:
LOT/SOIL CONDITIONS: ` �-
5
EQUIPMENT USED: (,•e
EQUIPMENT_APPROVED::
FRAME REMOVED: PERMITED BY MANUFACTURER:
(PRIOR TO 11/89) ,•
FOUNDATION TO LOCAL, BLDG CODE:i, ---
j
/
SPACING:
-) ` dklc-1 Cie .
LEE (
r
. L'; \,..,,. \ (2c"` ('x,v u C7k • lac:- T:
SUPPORT LOCATIONS PER MANUFACATURER`OR ENGINEERED DESIGN:
ELEVATION OF LOWEST FLOOR(IF. IN.A FLOOD HAZARD AREA):
SKIRTING: TYPE:
COMMENTS
ATTACHMENT TO HOME:
POLY ON GRADE:
t
ACCESS PANEL:
*FINAL APPROVAL MEETS THE REQUIREMENTS FOR TITLE ELIMINATION EXCEPT FOR PARK PLACEMENT*
INSPECTOR: /�' J DATE/TIME: -6 »;67
ORIGINAL COPY: CITY OF SPOKANE VALLEY ADDRESS FILE COPY FOR OWNER
*MIMI
COMM TEMP
SOX Munson
&taw FounskriatuforteFu r
FOUNDATION
CSUPPORTc-lirCHP3F
TORS
EARTHQUAKE BRACING
PLUMBING CONNECTIONS
i
SKIRTING
DATE OF FINAL INSPECTION
•
INSTALLER TAG
INSTALLER
CERTIFICATION
NUMBER
.enT rte+
cayo3
<9 903
(14403
INSTALLERS: PLACE NEAR % : i i i .. D' 1 . FILL IN
PERFORMED IN ► SIGN.
INSPECTOR: NUMBERS AND SIGNATURES
AND SIGN.
HOMEOWNER: STORE TAG IN HOME.(
Office of Mm sfacheed Housing, ice -964-0$52
SIGNATURE
Lico