2008, 07-23 Permit App: 08002844 Tie Downs InspectPermit Center
S°T®kane 11703 E Sprague Ave, Suite 13 -RECEIVED BY
Spokane Valley, WA 9920 lTY OF SPOKANE VALLEY
valley. (509)688-0036 FAX: (509)688-003,7
wn.suokanevallev.org .IJL 2 a 2000
PERMIT CENTER
Community Development
Manufactured Home
Permit Application
OTHER
PERMIT NUMBER: 3.4784
PERMIT FEE:
SITE ADDRESS: \Qll\ E-- Mme‘ (3-0F.S\3
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Building Owner:.al- -
Name: � �^ne = �P \\ M0.Yl
`
Address:
Irl ll1 � - 111\n>^\ • c� 0.+9e -
State:,
City: Ui-t8 Cr0cncst A",
Zipot9coi
Phone: Fax:
CleSci - q -16-77
Contact Person
Name:
Phone:'
Describe the scope-of_work in detail:
Contractor:
Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No:
Exp Date:
City Business Lic. No:
: •
'
11E_ OtDL> f15 €Y rrk (A.,o.x\ dsntc0, Ri6mt
MANUFACTURED HOME
Width:
2(0,
Length: He
Year: Pg9e)
Pit Set: >�
Septi ewer:
Manufacture:
Previous Address:
Proposed Use:
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the
dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The
signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done
in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of
Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordinances. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
Signature
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 8/23/2005
❑ Check
❑ Mastercard
Expires:
Date t1- 3-08
❑ VISA
VIN#:
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ROAD WIDTH: too
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COMMENTS
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