1995, 09-11 Permit App: 95007132 MHPROJECT NUMBER= 95007132 APPLICATION J DATE= 09/11/95 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED,FOR COMMENCING WORK WITHOUT A PERMIT
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SITE STREET= 19021 E MONTGOMERY AVE PARCEL#= 55082.0817
ADDRESS= OTIS ORCHARDS WA 99027
PERMIT USE= MANUFACTURED HOME REPLACEMENT
PLAT#= 000146 PLAT NAME= BARKER ROAD MOBILE HOMES 1ST A
BLOCK= LOT= 17 ZONE= UR -7 DIST#= G
AREA= F/A= F WIDTH= 70 DEPTH= 120 R/W= 60
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= BERTZ, LARRY L. PHONE= 509 926 3094
STREET= P O BOX 334
ADDRESS= OTIS ORCHARDS WA 99027
CONTACT NAME= LARRY BERTZ PHONE NUMBER= 509 926 3094
BUILDING SETBACKS: FRONT= 25 LEFT= 10 RIGHT= 10 REAR= 30
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING L & I INSPECTION FORM
COMMENTS:
BUILDING SETBACK REVIEW REQUIRED PEP- ►�I-TAC- Ej�) ll LE
COMMENTS: �"LAr1 (ZP ME• IkXAT(oN H�),[wt,�
HEALTHDIST INCREASE IN LOT COVERAGE�� L Cec,4- 7-,),,q6drm S 0-110
COMMENTS : ? // Q s' (-o
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER
YR/MAKE= 92/MARLETTE
SERIAL#=
ITEM DESCRIPTION
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INSPECTION FEE
STATE SURCHARGE
COUNTY SURCHARGE
PHONE=
MODEL=
WIDTH= 14 LENGTH= 70 HEIGHT= 10
QUANTITY FEE AMOUNT
--- -------- ----------
50.00
Y 4.50
Y 9.50
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
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PROJECT NUMBER= 95007132 APPLICATION DATE= 09/11/95 PAGE= 02
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
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MANUFACTURED HM 64.00.00 64.00
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64.00 .00 64.00
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: BURRIS, ROBIN
******************************** THANK YOU ************************************
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