2002, 05-09 Permit App: 02003539 MHProject Number: 02003539 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/9/02 Page 1 of 2
Project Information:
Permit Use: DOUBLE WIDE MANUFACTURED HOME Contact: EDGE, JAMES P
(EXISTING SINCE 1980) Address: 23211 N HATCH RD
C - S - Z: COLBERT, WA 99005
Setbacks: Front 30 Left: 46 Right: 5 Rear: 10 Phone: (509) 276-4600
Group Name:
Site Information: Project Name:
Plat Key: 002378 Name: SIESTA MOBILE PARK ADD District: F
Parcel Number: 45203.0133
Block: 1 Lot: 5
SiteAddress: 908 S NINA CIR
SPOKANE, WA USA 99206
Location:: SPO
Zoning: UR -7
Water District:
Urban Residential -7
Area: 7,500 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Site Plan Review
Plan Review
Owner: Name: EDGE, JAMES P
Address: 23211 N HATCH RD
COLBERT, WA 99005
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Originally Released: 5/9/02 By:
Released
MUST MEET CONDITIONS OF FIELD INSPECTION
Originally Released: 5/9/02 B
Septic System Review
-06v
Permits:
Operator: CKF Printed By: CKF
Print Date: 5/9/02
Project Number: 02003539 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/9/02
Contractor: OWNER
Item Description
INSPECTION FEE
COUNTY SURCHARGE
Manufactured Home
Firm: OWNER
Phone:
Units Unit Desc
2 SECTIONS
1 Y OR BLANK
Permit Total Fees:
Notes:
MUST MEET CONDITIONS OF FIELD INSPECTION
Fee Amount
$100.00
$22.00
$122.00
Payment Summary:. xrt u ; �� ,..� ��... .
Permit Type Fee Amount Invoice Amount Amount Paid
Manufactured Home $122.00 $122.00 $0.00
$122.00 $122.00 $0.00
Amount Owing
$122.00
$122.00
Page 2 of 2
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 contrued 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: CKF Printed By: CKF
Print Date: 5/9/02
1 1
SoxSpoKANECouTY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address:
qG< Ct_ .
Legal Description: to -r 4 �# -{ , �r t4 \/2 iA ,<6"--t 6
60e I , � r � �L k141 P ��h-L 44- yi
Assessor's Tax Parcel Number(s):
ka4te C 1;-zt.4:Z
Project Description:
❑ Building Permit
❑ Change in Use
❑ Grading
lanufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
Department Use Only
Water District/Purveyor.
Sewer District/Purveyor
Road width
Setbacks
Front Rear:
Left Right
School District
Fire District.
Zoning
OWNER/APPLICANT INFORMATION
El Indicate who should Waded renadima this hroiect
(..ner:06-r' �,^t'`pp7 e//vv�����F y�
c/ fy1,4 eK / ✓ w -
Phone: .,�,7�'i -',L IC fit'
lac '7 [ L C.' I
plicant: /� .p
44A-
Phone: • -7 -vee,
Das: 71.e, HI /
/---.C' �// 7�w/t_
Mailing Address:
-.- I
N
pA70 i-{
€' ,5-e
Occupancy group
Construction type
Mailing Address:
412
Deck sq. ft.
Circ, State, Zip
V fit
I feat source (electric, gas, etc.)
all-
C%
•
5
Cit', State, I
❑ Contractor
Phone
Fax
❑ Architect/Engineer
Phone
Fax
Mailing address
Mailing address
City, State Zip
City, State Zip
WA State Contractor license a
Contact name:
PROTECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2°a floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
I feat source (electric, gas, etc.)
Manufactured Home
Fire Safety
Sign
Width:
/
Length:
•
What is the square footage of the sign
face? i
How high is the sign?
Year:
/67 - g
Make:
/6/1ee1A,16,rr N
Value
# of signs
Area of existing signs
Inspector
Phone
O Concrete
Relocation
Fire Safety
Firm Name
Previous address
Phone
Fire Sprinkler
fent
Paint booth Fire Alarm
Fireworks display
_
Are there slopes greater than 30°%o on the property? (30 ft rise in 100 ft)
( /"/°) 0 Yes A No
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
Rr6 CbE(y/
Phone
Will the site be served by a septic system? Pi Yes O No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
0 Yes No
IZ
Are there slopes greater than 30°%o on the property? (30 ft rise in 100 ft)
( /"/°) 0 Yes A No
Are critical or hazardous materials used or stored on site?
0 Yes No
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? (;)1 Yes O No
If yes, identi' on site plan Cue-
What is the current property size? I /
(square feet or acres) -7 .1•J iC !Dd
, Is any part of the property within 250 feet of a shoreline?
Ifyes, ident ' on site plan O Yes A No
What is the current use of this property?
Rr6 CbE(y/
Is your property in a designated wildlife habitat area?
O Don't know O Yes 3111 No
Will the site be served by a septic system? Pi Yes O No
Is any part of the property within a 100 yr flood plain?
Ifyes, identz' on site plan
0 Maybe 0 Don't know 0 Yes 0 No
Are or will there be wells located on the property?
I f fres, itlentifr on the site p/an O Yes ,I' No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyes, ident ' on site plan 0 Yes 0 No
Is there evidence of fill or excavation on the property?
0 Yes No
IZ
Are there slopes greater than 30°%o on the property? (30 ft rise in 100 ft)
( /"/°) 0 Yes A No
Are critical or hazardous materials used or stored on site?
0 Yes No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
D Yes D No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes 0 No
D Yes D No
Is public water available to the site? 0 Yes D No
Is the property inside the PSSA? 0 Yes D No
Is the property located within 1000 feet of a Natural Resource Area?
DYes 0 N
Date Received:
Staff Representative
METHOD OF PAYMENT
VISA
❑ C:AsII ❑ C.III.CK ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
BANKCARD NUNIBI(R:
I P1R1•:S:
AU fl IOR1/.1'.D Sl<;N.v I UIW:
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $35.0011 EASE
O.\KE CI IECKS PAYABLE TO SPOIC\NE
COUNTY PERMIT CENTER
!-er '-1 ,A -ND 04,s- ,407- 5i
,11,2‘)c /, Si ES 274 m 6/ LH ,o4 -,e .47/7/Y,
t F 5 , M/r,4
C
!cKA cu
AanR7L-z17s v-16-
ZONE
ROAD I*, DTII 51
FRO\T_3C—FLANKING —
COMM 1 sS _
se of
fitted for the pubo
This inin plan is being g permit and and correct
isat��,p
a building proposal. All known Piercy nts
obtaining of the Prop and representation cut lines, structures ndWetlands,se
15, bee. nsienti indicated
are
lines' �`
Also r other critical areas.
� n dentifre ' slopes bodi�5 Ot W���r, stC-ei�