2006, 11-15 Permit: 06002042 InspectMANUFACTURED HOME
INSPECTION RECORD CARD
MUST REMAIN POSTED IN A CONSPICUOUS PLACE ON JOB SITE
JOB ADDRESS, / l 6, ihri. PROJECT NUMBER: 2-1,0 42
OWNER:
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MANUFACTURER: 17AM-1--i- y>)j:2 ;
CERTIFIED MANUFACTURED HOME WASHINGTON STATE
INSTALLER NAME: 5 p9/ri L4 Y /9 V) L4 INSTALLER CER 1 1-41CATION NUMBER: Y L
HUD #:
THIS SECTION FOR USE BYPERSONSRESPONSIBLE FOR SETUP/
INSTALLATION OF THE MANUFACTURED HOME
(I.E.: CERTIFIED INSTALLER OR HOME OWNER
PERFORMING 7HE WORK)
DESCRIPTION OF WORK
1. Construction of foundation
system footings:
2. Installation of support piers:
3. Installation/adjustment of
anchorage devices:
4. Connection to on site water,
sewer, electrical services:
5. Skirting/ventilation and
ground cover:
6. Extension of water heater TPR
valve, clothes dryer duct etc.:
7. Address posted and visible
from the road?
SIGNATURE DATE CERT. #
Gee
- J 61( (/47
((/c
ZZ j/
THE AUTHORIZED SIGNATURE BELOW WARRANTS THIS
MANUFACTURED HOME HAS BEEN INSTALLED IN ACCORDANCE
WITH W.A.C. 296-150M FOR MANUFACTURED HOMES AND/OR
THE MANUFACTURERS INSTALLATION INSTRUCTIONS.
5 /}_i7,c.c' r P G T' i Ct
CERTIFIED INSTALLERS SIGNATURE
OWNERS SIGNATURE (IF APPLICABLE)
HOME OWNER: RETAIN THIS COOYIPLETED INSPECTION CA
THIS SECTION FOR COUNTY USE OILY
INI TIAIS DATE
Site Review/
Site Preparation:
C�thrr_
AREA
SPOKANE VALLEY
NOTICE OF INSPECTION
PROPERTY ADDRESS:
l $4' 6 F /17//0)1
PROJECT NO off, 2-04 2—
OWNER OWNER
CONTRACTOR
INSPE�CTION TYPE:
STATUS OF WORK LISTED ABOVE:
A OVED CORRECTIONS
NEEDED
NOTES:
BY:
INSPECTO
QUESTIONS? CALL OUR OFFICE:
BUILDING DIVISION
(509) 688-0036
OFFICE INSPECTION LINE (509) 688-0054
CALLED IN:
j
DATE
TIME
City of
SPOKANE VALLEY BUILDING DEPARTMENT
11707 &Sprauge Avenue, #106, Spokane Valley, Washington 99206 Tel. 509-688-0036 Fax 509-688-0037