1999, 11-05 Permit App: 99010766 MHProject Number: 99010766 Inv 1
- Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/05/19 I'age I of 2
Project In/orrnation:
Permit Use:
Site Information:
PLACEMENT OF SINCLE\IDE MOBILE HONIE
14X70
Setbacks Front 150 Left: 10 Right: 75 Rear: 350
Contact: ALDERETE, NIARTIN & RON
Address: 3003 N LOCUST
C - S - Z SPOKANE, WA 99206
• Phone: (509) 924-2978
Plat Key: 002044 Name: PLAT"A" GREENACRES 1RR.DIS
District: G
•
Parcel Number: 55073.0209
SneAddress. 17510 E MONTGOMERY A
GREENACRES, WA 99016
Location:: GRE
Zoning: S14-1 Suburban Residential 1
Water District.
Owner. Name: ALDERETE, MARTIN & ROND
Address: 3003 N LOCUST
SPOKANE, WA 99206
Hold: ❑
Area: 1 Sq Ft Width: 100 Depth 630 Right Of Way (ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 0
Review Information:
Department Review
BUILDING Site Plan Review
BUILDING
Comments:
Comments:
HEALTHDISTRICT
Comments:
�^J
Permits: •L
Plan Review —-557 _�
Septic System Review
61ana/actured Home
Contractor: OWNER Firm: OWNER
Address: 0 Phone (000) 000-0000
000000, 00 000000
Item Description •
STATE SURCHARGE
INSPECTION FEE
COUNTY SURCHARGE
Sec, Art ,
\00 (71/6)
Units Unit Desc
1 Y OR BLANK
1 SECTIONS
1 Y OR BLANK
Fee Amount
$4.50
$50.00
$11.00
Permit Total Fees: $65 50
Project Number: 99010766 Inv: 1
•
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/05/19 Page 2 of 2
Payment Stntusarv:
Operator: Iii�F•(
Permit "Type "D
Manufactured Home
Notes:
Printed 13y: CKF Print Date:
Fee Amount Invoice Amount
$65.50 $65.50
11/05/1999
Amount Paid
$0.00
Amount Chyme
. $65.50
$65.50 $65.50 $0.00 $65.50
Department of Labor & Industries
Factory Assembled Structures Section
INSTRUCTIONS:
1. Complete all spaces, including the signature box (marked with an X).
2. Draw a map on reverse side of WHITE copy only.
3. Forward completed permit and fees to the nearest L&I office. See list on reverse.
4. Contact and schedule the inspection with the same L&I office within 15 days.
ALTERATION PERMIT
Do not complete shaded areas
"Permit N 123652
Invoice R
Insignia 0
Owner1 }I last name
Address
>cr �. • LC(
,,first name
Installer/Contractor/Dealer
1-"i)
..z t ; { ;
Address
`11 (t) t,--
Check the appropriate boxes in section A and section B.
A
Commercial Coach
Serial No.
Mobile Home
Serial No.
HUD No.
UlRecreational Vehicle or
Serial No.
Park Trailer
Model No. or Plan Approval No,
Day time phone
to `r / /T 111/
City
} 'Yr'. 11 (.
Phone
(2)
City
), ), 1/(i 11 c_
Date
State ZIP
Contractor's registration number
State ZIP+4
FEES
B LaAlteration Inspection (check appropriate boxes below) $
Air Conditioning/Heat Pump
Electrical
PAW
Electrical AppliffM.TMENT OF LABOR & INDUSTRIES
Fire Safety
`Gas Furnace
Gas Piping
Plumbing
Structural
Wood/Pellet Stove — —
Plan Review
RV Inspection
Reinspection
Technical Inspection
NOV 0 5 1999
SeJl'JbdION G
SPOKANE, WA
Original Permit
No.
Note: This permit expires one year after date of purchase. (Non-refundable)
("Signal ru e of�pplicant 2r authorized represenIIVC r Make check payable to: Dept. of Labor & Industries
+,1��Ci, r, �� (� CI k-► c77-
FEES DUE .
Department use only
Request approved or ❑ Request denied because of specific violations of Washington rules and regulations. Violations must
be corrected and reinspection requested within 10 days for recreational vehicles and 20 days for mobile homes and commercial coaches
of the notice of violation date. (This does not apply to technical inspections). It is unlawful to offer for sale, rent, or lease any
non -complying mobile home, commercial coach or recreational vehicle.
ALTERATION PERMIT
CALL 324-2568 FOR INSPECTION
PLS GIVE PERMIT NUMBER
DIncluded are forms requ'red which must be completed and fees submitted before reinspection.
Date
Area office
Inspector
F622-012-000 alteration permit 10es White -Olympia Canary -inspector Green -Contractor Pink -Purchaser Goldenrod -Purchaser
Project Number: 99010766 Inv: 1
�lication
Date: 11/05/19 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use:
Lt:r ,.,; i;: f' . '.`>a1 .. .:3::.,. ;:['T.' F.::.• .. . ,.'•' q::. v '-'1.r, 4,,vret •t:;3&lVT_..[d .R f.N i=';'+Z" .tYvamn #:-t• 4
PLACEMENT OF SINGLEWIDE MOBILE HOME Contact: ALDERETE, MARTIN & RON
14X70 Address: 3003 N LOCUST
C - S - Z SPOKANE, WA 99206
Phone: (509) 924-2978
Setbacks: Front
150 Left: 10 Right: 75 Rear: 350
Site Information:
Plat Key: 002044 Name: PIAT"A" GREENACRES IRR.1)IS District: C
Parcel Number: 55073.0209
SiteAddress: 17510 E MONTGOMERY A
GREENACRES, WA 99016
Location:: GRE
Zoning: SR -1 Suburban Residential 1
Water District:
Area: 1 Sq Ft Width: 100 Depth: 630 Right Of Way (ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 0
Owner: Name: ALDERETE, MARTIN & ROND
Address: 3003 N LOCUST
SPOKANE, WA 99206
Hold: ❑
Review Information: ):?.7 T.
Department Review
BUILDING Site Plan Review
Comments:
BUILDING Plan Review
Comments:
HEALTHDISTRICT
Comments:
Permits: s 1110 ,1173: 111VEMAM 4STIV ^.nor:::
i'aw ,Z,ANW:.W.:hIriz,tagi;..8" ,6_:R'yg{%.-:::s.1.2,i.7111111116,
Septic Systei.i Review
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
STATE SURCHARGE
INSPECTION FEE
COUNTY SURCHARGE
Sewage system designed
fac bedrooms only, �y/,
117x -99
^i)P.'?Td .�.5S4i'7iHfSMMi;_!.is1FFFi13M2R.id't,7.f;ttJCit1'.:11,v,'44.404,. .... C_.. .. MMEM,.:
Manufactured Home
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 Y OR BLANK
1 SECTIONS
1 Y OR BLANK
Permit Total Fees:
2
Fee Amount
$4.50
$50.00
$11.00
$65.50
ALL SETBACKS INDICATED ARE
FROM THE PROPERTY UNE OR
CENTER LINE OF RIGHT- OF -WAY
WHICHEVER IS MOST RESTRICTIVE
THE CURB IS NOT NECESSARILY
THE PROPERTY LINE
ADDRESS:.757 0 MOA4e
ZONE: L 7 1
ROAD WIDTH: I , )
FRONT.
COMMENT
RFVIEWE
KI
Q
r --
lira I rid agrlift.12ha:r
This site plan is being submitted for the purpose of
obtaining a building permit and is a true and correct
representation of the proposal. All known property
lines/dimensions, curb !nes. structures and easements
have bee- ified. Also indicated are wetlands,
bodies • O steer - lopes ot er ntical . r
Signed: -
Date
Ner--- UJ
r
PevrIOY-vi
.1