2008, 02-28 Permit App: 08000467 MHProject Number: 08000467 Inv: 1 Application Date: 2/28/2008 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Permit Use: 197124 X 50 MANUFACTURED HOME -ROYAL
Contact: BAKER, H
Address: 19224 E MONYGOMERY
C - S - Z: SPOKANE VALLEY WA 99027
Setbacks: Front Left: Right: Rear:
Phone: (509) 928-4194
Group Name:
Project Name: 197124 X 50 ROYAL S4468 MANU FACT
Site Information:
HOME
Plat Key: 000146 Name: BARKER ROAD MOBILE HOMES ADD District: East
Parcel Number: 55082.1111 Block:
Lot:
SiteAddress: 19110 E MONTGOMERY DR
Owner: Name: GUNDERSON, MARK A
Address: 19110E MONTGOMERY DR
Location:: CSV
SPOKANE VALLEY, WA 99027-95
Zoning: CF Community Facilities
Water District:
Hold: ❑
Area: 12,072 Sq Ft Width: 80
Depth: 113 Right Of Way (ft): 60
Nbr of Bldgs: 2 Nbr of Dwellings: 1
Review Information:
Review
Building Plan Review
Septic Sys Review
PER HEALTH
Released By:
Originally Released: 2/26/2008 By: tmelbourn
Released By:
Originally Released:
Landuse/Zoning/HE Conditions
2/28/2008 By: jdavis
Released By:
Originally Released: 2/27/2008 By: CJJANSSE
Permits:
Operator: jmm Printed By: JD Print Date: 2/28/2008
Project Number: 08000467 Inv: I Application Date: 2/28/2008 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Item Description
INSPECTION FEE
Manufactured Home
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc Fee Amount
2 # SECTIONS $100.00
Permit Total Fees: $100.00
Notes:
SEWAGE SYSTEM DESIGNED FOR A MAXIMUM OF 2 BEDROOMS OR 240 GALLONS PER
DAY. OCCUPANCY NOT ALLOWED UNTIL SYSTEM INSTALLATION HAS SRHD
APPROVAL
Payment Summary: ,
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Manufactured Home $100.00 $100.00 $0.00 $100.00
$100.00 $100.00 $0.00 $100.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: jmm Printed By: JD Print Date: 2/28/2008
Project Number: 08000467 Inv: 1 Application Date: 2/19/2008 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Protect Information:
Permit Use: 197124 X 50 MANUFACTURED HOME -ROYAL Contact: BAKER, H
Address: 19224 E MONYGOMERY
C - S - Z: SPOKANE VALLEY WA 99027
Setbacks: Front Left: Right: Rear: Phone: (509) 928-4194
Group Name:
Site Information: Project Name: 197124 X 50 ROYAL S4468 MANU FACT
HOME
Plat Key: 000146 Name: BARKER ROAD MOBILE HOMES ADD District: East
Parcel Number: 55082.1111 Block: Lot:
SiteAddress: 19110 E MONTGOMERY DR Owner: Name: GUNDERSON, MARK A
Address: 19110 E MONTGOMERY DR
Location:: CSV SPOKANE VALLEY, WA 99027-95
Zoning: CF Community Facilities
Water District: Hold: ❑
Area: 12,072 Sq Ft Width: 80 Depth: 113 Right Of Way (ft): 60
Nbr of Bldgs: 2 Nbr of Dwellings: 1
Review Information:
Building Plan Review
Septic Sys Review
Released By: '�T! LCq
Released By:
Landuse/Zoning/HE Conditions Released B
Permits:
Manufactured Home
Contractor: OWNER
Item Description
INSPECTION FEE
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
2 # SECTIONS
Permit Total Fees:
Operator: jmm Printed By: jmm Print Date
Fee Amount
$100.00
$100.00
2/19/2008
Project Number: 08000467 Inv: 1 Application Date: 2/19/2008 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
Payment Summary:.
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Manufactured Home $100.00 $100.00 $0.00 $100.00
$100.00 $100.00 $ 0.00 $100.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: jmm Printed By: jmm Print Date: 2/19/2008
02/27/2008 09:17 509324156! JMr11) r-nz) p.01�04
FEB 2008 14 r 12 FR 5U PERMIT CENTER 5096880037 TO 93241567
Date: 2/19/2008 Page 1 of 2
Prot"cr. 08#00467 Inv:1 Application
�s
THIS IS NOT A PERMIT
�1J x
�® 4 ties will be assessed for comnnenclug work without a permit
69t Use: 197124 X 50 MANITFAU. E
CTP" HOM-ROYAL Contact: BAKER, S
Address: 19224 B IVIONYGOMERY
C. 5 - Z: SPOKANE VALLEY SVA 99027
Rear- Phone: (509) 92"194
Setbacks: Front Left: Rio: Group Name:
Project Name: 197124 X So ROYAL 54466 MAN[/ FACT
Sitz 1'nfa% ROME
ROAD MOBELE SOMFS ADD District: East
Plat Key.- 000146 Name: BARKER ..
parcel Number: 55082.1111 Block: Lot:
SiteAddress: 19110 E MONTGOMERY DR Ovvnw. Address- ra91D10 E MONTGOMERY DR
SPOKANE VALLEx, WA 99027-95
Location:: CSV
Zoning: CF Commatnity Fulllties
Weer District; /Hold: �
Area: 12,072 Sq Ft Width: 90 Depth 113 Right Of Way (R): 60
Nbr of Bldgs: 2 Nbr of Dwelling: 1
Review ,in orM90
aiieylew _
Building Pian Review
,%ptte Sys Review n
SOcvage s stEm desi .forana
sc rooms, or allons . er da
svr.�_tv
���41+�ED-ur
. ,trtil3e�—�f /4
installation has SRHD acro
Landow JZoningH'I� JCoRdittans Raleeil
JlMenufiewred Home . --
Contractor: OWNER Firm: OWNER
Phone: (000) 0000000
Iced Units 1alit.l?= Fee mount
INSPECTION PEE a # SECTIONS $100.00
permit Total Fooc: $100.00
Operator. Jam Printed. By: JMM Print Date: #19/2008
FEB 27 2008 09:16 5093241567
PAGE. 01
1W
X-ICITYokane
jW1ey-
Community Development
Permit Center r r
11703 E Sprague Ave, Suite B-3 RE.
Spokane Valley, WA 99206 CIT`( O
(509)688-0036 FAX: (509)688-0037
www. spokanevalley. o rgy
Manufactured Home
BY:
Permit Application ❑ OTHER
SITE ADDRESS: /,?//L,) '1!5.
/-.A.
LEGAL DESCRIPTION:34&W a MW— ,ST AlSd 6 /O
PERMIT NUMBER:
PERMIT FEE:
ASSESSORS PARCEL NO: Jc-
508o . / / /
Building Owner:
Name: A/ , 44'hee, 4
Address:/ 0--2 6, Nb/(-ZZDet-L�li�/
City: zmb�- i%ma ec% State:" ZipW'�L'7
Phone: ., p , */ 9 Fax:
Contact Person
Name: ev
Phone:J b�I gql
Contractor:
Name:
Address:
City: State: Zip:
Phone: Fax:
Contractor Lic No: Exp Date:
City Business Lic. No:
Describe the scope of work in detail: MAJjl jC�A CZE i-& AtE 6,J
MANUFACTURED HOME
Width: o�� �a Length: t Year: Iq /I/ Pit Set: ap Septic/Sewer:
Manufacture:
Previous Address: -:567— N A5&)
Proposed Use: ;—>65 i l e'd e e
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 care processed.
Signae Date 1 b
Method of Payment: II
❑ Cash EY Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005
ly
RECORD DRAWING
DEPT. APPROVED
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3604 N. Kenney Rd
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CITY COPY
THIS BUILDING SUBJECT
TO FIELD I NSP ECTIO'N, CORRECTIONS
1 7
REVIEWED FOR C`�°'r'i COMPLIANCE
SPOKANE VALLEY NG D1 ISION
2-� t7?