1999, 03-31 Permit App: 99002479 MHProject Number: 99002479 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work with'=ut a permit
Date: 3/31/99 Page 1 of 2
Proiect Information:
Permit Use: NEW DOUBLE WIDE MANUFACTURED HOME
Setbacks: Front 37+ Left: 17 Right: 7 Rear: NA
Site Information:
Plat Key: 005236 Name: ARMSTRONG ESTATES
LIdal
Parcel Number: 45134.2307
Contact:
Address .
C -S-7
Phone
Distri(
1Y CORDES/SEDROC CONS
I t 123 S MEDICAL LAKE RD
tEDICAL LAKE, WA 99022
;09) 499-0383
SiteAddress: 16513 E NIXON CT Owner Name: JOHNSON, 1
VERADALE, WA USA 9903 Address: 16513 E NIXON t"T
Location:: VER VERADALE ` , !% 99037
Zoning: UR 3.5 Urban Residential 3.5
Water District: 010 VERA
Hold: 0
Area: 10,935 Sq Ft Width: 80 Depth: 140 Right Of \n
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Denartment
BUILDING
Comments:
Review
Site Plan Review
(ft): 50
BUILDING Plan Review
i Comments:
r
ENGINEE
tOLA r-ircbt_ p-eA,4-ec2.6L-4-;az/c)
Approach / Drainage
Co
UTILITIES
Permits:
Comments:o
Sewer Review
y0—,--A---r19_17 -
4/3/*'-fNp /93 Lift
Q�
Contractor: UNKNOWN
Address: UNKNOWN
UNKNOWN, WA UNKNOWN
Item Description
STATE SURCHARGE
INSPECTION FEE
COUNTY SURCHARGE
Manufactured Monne
Finn: UNKNOWN
Phone: (000) 000-000
Units Unit Desc
1 Y OR BLANK
2 SECTIONS
1 Y OR BLANK
Permit Total Fees:
Fee Am• , i
$1(�
$12
Project Number: 99002479 Inv: 1 Application Date: 3/31/99 Page 2 of 2
THIS IS NOT A PERMIT
Penalties win be assessed for commencing work without a permit
Payment Summary
Operator: JAS
Permit Type
Manufactured Home
Printed By: JAS Print Date: 3/31/99
Fee Amount Invoice Amount Amount Paid Amount Owing
$126.50 S126.50 $0.00 $126.50
S126.50 $126.50
$0.00
Notes:
..:
BUILDINGS RESTRICTED TO 14 UNITS UNTIL PROPOSAL IS CONNECTED TO PUBLIC
SEWER. BUILDING SETBACKS SHALL BE MEASURED 25 FEET FROM THE EDGE OF THE
RESERVED FUTURE AQUISITION AREA.
S126.50
n
a)
0
PLICATION INFORMATION
hat is the ,l , SIT address?
/xon __.'
Legal description as it appears on the property deed
OWNER or OCCUPA
ailing address
1/4573 2VY?
gre77,X-/(</
City, state
ho should we contact regarding this project?
C/777s6r
ASSESSOR'S tax parcel number?
What work is being done under permit?
qpitw auf,„k 4d4,1koinv,Aj-
one:
Phone
9017 —Grp.;
-t/1(.
Phone
Zip
ater district
Buildi
Contractor
inspector district
Property Pro size
Night of :Way width:
WA State Contractor license #
Mailing address
Building height
Dimensions
# of stories
TOTAL SQUARE FOOTAGE
Main floor area
Architect/Engineer
2nd floor area
Unfinished basement area
Finished basement area
hat is the heat source?
anufactu
Width:
Year:
Garage area
Size of decks, etc.
9'9
Installer a
cd(7d C (&i3t:
Length:
Make:
5'6
What is the cost of your project?
What is the square footage of
the sign face?
ow high is the sign?
//1///c/./
Wa State Contractor license #
Mailing addr
Previous address
Contractor
Contractor
0h( C0/3/JL.9,/1/
Wa State Contractor license #
Mailing address
ire;: Safe
Fire Sprinkler
Paint booth Fire Alarm
VALUE
Tent
Fireworks display
WA State Contractor license #
Mailing address
Contractor
WA State Contractor license #
arage' Tan
(Circle one) Above -ground Underground
Contents of tank(s)
Contractor
'Size / gallons
Mailing address
Swimming Pawl
Size / gallons
Wa State Contractor license #
a -
Mailing address
Contractor
Private
Public/semi-private
'WA State Contractor license #
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
/110
Site Plan
9
G�Jin\���►.MEM MN MIMil III
NMI III
1111
NMI IIII
NIIIMAll NM III
•NisiN Imo .1
" ` % .0 I. L4 I I I
MO MI I
111111111111111111111111
NI - PIM I NI
1.
RIM • im
III MIN
111/1111 FPO— err rw�NI11111 El =MI
NEM ' III III
� -�� �,
imilum,
II
111
=MIN --- ' - ,� 1114-11
_ice.1111 _
I N
L. I�
c
INCLUDE THE FOLLOWING:
❑ All roadways, driveways & easments
❑ Distances from center of roads, right of ways,
private roads & property lines
❑ All existing & proposed buildings
❑ Underground utilities
❑ North arrow
❑ Septic tanks & wells