1995, 06-07 Permit App: 95004038 MHPROJECT NUMBER= 95004038
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APPLIC\TION
THIS IS NOT A PERMIT
DATE= 06/07/95 PAGE= 01
******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
(SITE STREET= 19111 E MARIETTA AVE
ADDRESS= OTIS ORCHARD WA 99027
PARCEL#= 55082.1316
PERMIT USE= NEW DOUBLE WIDE MANUFACTURED HOME
PLAT#= 000146 PLAT NAME=
BLOCK= 13 LOT=
AREA= 00000000 F/A=
# OF BLDGS= 1 # DWELLINGS=
BARKER ROAD MOBILE HOMES 1ST A
16 ZONE= UR -7 DIST#= G
F WIDTH= 70 DEPTH= 117 R/W= 60
1 WATER DIST = CONSOLIDATED IRRG #1
OWNER= HELLMAN, JEROME & LAVONNE
STREET= 19111 E MARIETTA AVE
ADDRESS= OTIS ORCHARD WA 99027
PHONE= 509 926 2636
CONTACT NAME= LAVONNE OR JEROME HELLMAN PHONE NUMBER= 509 926 2636
BUILDING SETBACKS: FRONT= 25 LEFT= 10 RIGHT= 18 REAR= 66
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DEPARTMENT
BUILDING
COMMENTS:
THDI3iP
COMMENTS:
REVIEW INFORMATION *****************************
REVIEW REQUIREMENT
SETBACK REVIEW REQUIRED
LQ--Z-`7'S
NEW OR IIDDITIONAL WASTE WATER
MOBILE HOME PERMIT *****************************
CONTRACTOR= ALLIED CONTRACTORS OF SPOKANE
STREET= 4620 N STARR RD
ADDRESS= OTIS ORCHARDS WA 99027
YR/MAKE= 1995 NASHUA
SERIAL#= 34748
ITEM DESCRIPTION
PHONE=
MODEL=
WIDTH= 26 LENGTH= 42 HEIGHT= 00
INSPECTION FEE
STATE SURCHARGE
COUNTY SURCHARGE
PERMIT TYPE FEE AMOUNT
QUANTITY FEE AMOUNT
2
Y
Y
100.00
4.50
18.00
AMOUNT PAID AMOUNT OWING
PROJECT NUMBER= 95004038 APPLICATION DATE= 06/07/95 PAGE= 02
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 122.50 .00 122.50
122.50
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULIE SHATTO
.00 122.50
•******************************* THANK YOU ************************************
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APPL CA1ION INFORMATION
'What is the JOB SITE address? ASSESSOR'S tax parcel number?
E e 1c11 \ 1 rn n r. aR Dia`s OccloAccis �7FisIn. 01(\o2:7
Legal description as it appears on the property deed - 11 - -
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OWNER or OCCUPANT - •` - • i-4‘ Phone
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Mailing address City, state Zip
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Who should we contact regarding this project? Phone
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What work is being done under this permit? '
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qG 4�E tory, �, O�.l 1 n
ZoneH. :
Inspector district „ •
Property size
Hight _of way width
•iC15'
Water district
Building
Building height
# of stories, .
Contractor ' __ _ --
Dimensions .. - -s - 1,
TOTAL SQUARE FOOTAGE :
WA State Contractor license # -: "' "-
Main floor area " '
Unfinished basement area
Mailingiaddress, J , 1
2nd floor area
Finished basement area
Architect/Engineer •
" i I i
Garage area
"•
Size of decks, etc,
.. . ' 1 ,
What is the h' at source? 1 ", 1
What is the cost of your project?
Manufactured Home ':
..
Sign
.. .,.
Width: I / `_.,.-f_ \
f-
Length: ` / f ,._ ".
What is the square footage ofHow high is the1eign7
the signface) � l
Year: - - — -
i
\ j
Make:. -' -
"Nast,jar-. j...
y� ).
Installer j' \ `
n'` C 't',\ COrJT G 1:,,,-s -
Contractor
Wa State Contractor license #R11.ZEcs \102 1_
Wa State Contractor license #
Mailing addrea % ktz2.6 - NS a �q e.; (Z a . - -
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C.A- 5€.0rLI•>Ads �kia:515, ri-9 o27
Mailing address ;
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Relocation:-:,..----- '_;:_. .<,:.
Fire Safety. ,, " ..".""
Previoui ail dress .1
j. ',' + 'Ns i
Fire Sprinkler_ 'Tent
L � Li, t '
- 'oa.-
Paint booth _ Fire Alarm _ Fireworks display
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VALUE
Contractor . -IS-
-..,
Contractor . '
WA State Contractor license # -• . r
i
WA State Contractor license/4
Mailing address .`' - - - -- ,
.. .. .., f 1 r t
Mailing address . _.
•
:.
Fuel Storage Tanks
Swimmin Pool --., ..
g�
(Circle one) Above -ground ' Underground "
Size / gallons
Private
Contents of tank(s) r - -'
Size / gallons
..
Public/semi-private
Contractor ,
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•
Contractor
,-•i.._ 1-
Wa State Contractor license # •
WA State Contractor license #
Mailing address - --1 - -
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Mailing address '
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OMPLETE 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.
Site Plan
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INCLUDE THE FOLLOWING:
❑ All roadways, driveways & easments
❑ Distances from center of roads, right of ways,
private roads & property lines
❑ All existing & proposed buildings,
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❑ Underground utilities
❑ North arrow
❑ Septic tanks & we_ IIS
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