2001, 05-07 Permit App: 01003300 MHProject Number: 01003300 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/7/01 Page 1 of 2
Project Information:
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Permit Use: NEW DOUBLE WIDE MANUFACTURED HOME Contact: ARMSTRONG, MEL
Address: PO BOX 366
Setbacks: Front 54 Left: 10 Right: 45 Rear: 25
Site Information:
MilitNESSMIXISSISSIMMMVSNOPMMI', .14 ',W.
Plat Key: 005236 Name: ARMSTRONG ESTATES
C - S - Z: VERADALE, WA 99037
Phone: (509) 990-6366
Group Name:
Project Name:
District: F
Parcel Number: 45134.2313 Block: 2
SiteAddress: 16612 E NIXON CT
VERADALE, WA USA 99037
Location:: VER
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Area: 10,433 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: messnermainzawassellIMIPAW,MEISOS
Lot: 13
Owner: Name: ARMSTRONG, MEL
Address: PO BOX 366
VERADALE, WA 99037
Hold: ❑
Depth: 0 Right Of Way (ft): 50
Department
BUILDING
Hold Reasons:
Permit Conditions:
BUILDING
Hold Reasons:
Permit Conditions:
ENGINEER
Hold Reasons:
Permit Conditions:
UTILITIES
Hold Reasons:
Permit Conditions:
Permits:
Review
Site Plan Review
Plan Review
Approach / Drainage
Released By:
Sewer Review
Project Number: 01003300 Inv: 1
4
Application
Date: 5/7/01 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Manufactured Home
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000) 000-0000
000000, 00 000000
Item Description Units Unit Desc Fee Amount
INSPECTION FEE 2 SECTIONS $100.00
COUNTY SURCHARGE 1 Y OR BLANK $22.00
Permit Total Fees: $122.00
Payment Summary:.
Operator: MKC Printed By: MKC Print Date: 5/7/01
Permit Type
Manufactured Home
Fee Amount Invoice Amount Amount Paid Amount Owing
$122.00 $122.00
$0.00 $122.00
$122.00
$122.00
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.
$0.00
$122.00
Aiiitilik
SPOIcAM COUNTY
0 1 - 3300/7)A)
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: / L 1 A i n o( C -T
Assessor's Tax Parcel Number(s):
Legal Description:
Ljc/c 2
L oT /3
Project Description: A
O Building Permit
O Change in Use
O Grading
Jvlanufactured Home Permit
O Relocation
O Sign
O Tenant (New/Change) 0 Other
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted r ardi
❑ Owner: Phone:
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mei f}/2 %,--r /ed , c Fax:
❑ Applicant: l h
r
Phone:
Fax:
Mailing Address:
.pri?o)c
LId
Mailing Address:
Main floor sq ft
./--0
iiy, State, Zip
Ve2,90A-/st
J4• 99037
Ciry, State, Zip
2nd floor sq. ft.
0 Contractor
S/¢- /tet e.
Phone
Fax
0 Architect/Engineer
Phone
Fax
Mailing address
Cost of project
Mailing address
City, State Zip
Ciry, Sn[e Zip
WA State Contractor license 1
Contact name:
P
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+x��-.4 . 6 ' -,4----;"P�-S .'�3a? '• .. $:.'*r '; s.
,
Building height to peak
A i Y )-
ii of stories
Main floor sq ft
./--0
Unfinished basement sq. h.
Dimensions
Total habitable space
2nd floor sq. ft.
Finished basement sq ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. h.
Cost of project
Heat source (electric, gas, etc.)
Width: Length:
P‘ 10 5-/i
1
Year:
p6Q
Make:
£. !/e 0t(
What is the square footage of the sign
face? b x_i
efrler
# of signs
How high is the sign?
Area of existing signs
Firm Name
Inspectors:
Phone
0 Concrete 0 Welding 0 Bolting 0 Reinforcement
ADDITIONA
Are there structures on the property? 0 Yes /``r No
If yes, ident fy on site plan
What is the current property size? 1
(square feet or acres) /Ltt 0 0
Is any part of the property within 250 feet of a shoreline?
If yes, identify on site plan 0 Yes INN No
What is the current use of this property?
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes No
Will the site be served by a septic system? 0 Yes No
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
0 Maybe O Don't know 0 Yes .(No
Are or will there be wells located on the property?
1f yes, identify on the site plan O Yes X No
Are there any wetlands, streams or ponds within 200 feet of the
property?
Ifyes, identih, on site plan 0 Yes X No
Is there evidence of fill or excavation on the property?
0 Yes ,.No
.
Are there slopes greater than 30% on the property? (30 ft rise in 100 h)
( / %) 0 Yes A No
Are critical or hazardous materials used or stored on site?
O Yes ,No
DEPARTMENT USE ONLY
Date Received
Staff Representative:
METHOD OF PAYMENT
MEM
❑ CASH El CHECK 9 am=❑
DIfOOVEZ
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE
EXPIRES:
SUBTOTAL
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This
si g� u being wed for the purpose of
oernat of ilding permit and is a true and correct
proposal. A
lines/dimensions, curb n structures end
easementsay
have been identified. Also Indicated rewetlands.
Wadies of abler. a , alone. or other critical areas.
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ZONE
ROAD 1/\:!D ri 7'
FRONT_
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