2005, 02-16 Permit App: 05000500 MH Project Number: 05000500 Inv: 1Ap-410 plicat on Date: 02/16/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SINGLE WIDE MOBILE HOME FOR Contact: HARRISON,DAVID
DEPENDENT RELATIVE(TUDR-03-04) Address: 12208 E PORTLAND AVE
C-S-Z: SPOKANE VALLEY,WA 99216
Setbacks:Front 59 Left: 15 Right: EX Rear: 20 Phone: (509)747-7396
Group Name:
Site Information: Project Name:
Plat Key: 001038 Name: GRANDVIEW ACRES District: Nort
Parcel Number: 45044.0507 Block: Lot:
SiteAddress: 12208 E PORTLAND AVE Owner:Name: HARRISON,DAVID
Address: 12208 E PORTLAND AVE
Location::CSV SPOKANE VALLEY,WA 99216
Zoning: AGRI
Water District: Hold: ❑
Area: 1.00 Acres Width: 0 Depth: 0 Right Of Way(ft): 40
Nbr of Bldgs: 1 Nbr of Dwellings: 2
Review Information: ;: Ply , . um ff un. .. ma, .. ;r kn,, m. w..,Nrg,, m,u _Isp-.
Review 1
Site Plan ReviewReleased,By:
'1
-LTA L.L OP3 -0'4)
Plan Review Released By: JA,Vit ,1102e I
A
Special Inspections /0. ('(---4.L atkA RRleased`;By: nil_. 1 f'{ f
- %. L,--1P4-6-\, ----d----- P - A 0 .,- ' - Lik'rki' ed L4- , e 6 i tVX
c...400.,
eptic System Review ...ha ot,
Released';By: ki/ / t( jti ' ,
I,rtb 1 . /65_,---
Permits: �tt ",tM .. , . e. .;_ :amu..,, ti Z A m - ria
.�
gW' 4 S616
0 i- 54wAvyte
Operator: K_C Printed By: K_C Print Date: 02/16/2005
Project Number: 05000500 Inv: 1 Application Date: 02/16/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Manufactured Home
Contractor: MOBILE CORRAL HOMES INC Firm: MOBILE CORRALL HOMES INC
Address: 15906 E SPRAGUE AVE Phone: (509)928-3003
VERADALE,WA 99037
Item Description Units Unit Desc Fee Amount
INSPECTION FEE 1 SECTIONS $50.00
Permit Total Fees: $50.00
Notes a „a,: _. . au ,= 2%G. ATA,... �t ....San n,E AM,
STOP WORK ORDER PLACED IN THE 12200 BLOCK OF EAST PORTLAND.PLACEMENT OF
MANUFACTURED HOME
Payment Summary' ;,, . .vor..... .MEM effir ,:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Manufactured Home $50.00 $50.00 $0.00 $50.00
$50.00 $50.00 $0.00 $50.00
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: K_C Printed By: K_C Print Date: 02/16/2005
_, BUILDING PERMIT APPLICATION WORKSHEET
Scii' WI ane City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
410
V a�.1 Spokane Valley, WA 99206
e
Y Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: V E I ld rj -DM,1060,(0 U t7 VvT{
crpoc
Assessor's Tax Parcel Number(s):
Legal Description: t—, ' `�
IK-
PERMIT DESCRIPTION: - I- — 0-2) --01-(
17 Building Permit . fl Change in Use [l Grading 7 Manufactured Home
n Relocation Tenant Improvement [1 Fire Safety 7 Other
OWNER/APPLICANT INFORMATION
H Owner: ,/ SO^ ❑ Applicant:
Phone: '`.'.IG11its�� - Phone: Fax:
addle s:' .. _sl. fl II Erle. Address: .
ity S - • Zip Code City State Zip Code
Contractor: _% 1 , _ LA, , I H Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
WA State Contractor License #: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES:
MAIN FLOOR TO SQ. FTG: 2ND FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: . DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
# OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
SYSTEM?
MANUFACTURED. HOME
Width: I Leng-h: f k Year: 1 -1h 'c) Pit Set:
Manufacturer:
.r_'i..: a_a
RELOCATION
Previous Address: .
Proposed Use:
•
•
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
•
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
•
Plans Examiner: Phone: Fax:
•
Address:
City State Zip
Inspector: Phone: ;Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
I I BOLTING n CONCRETE I I REINFORCEMENT f WELDING
Firm Name: Phone: • Fax:
Inspector(s):
DISCLAIMER
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.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
•
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
n Cash n Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: • Expires: VIN#:
Authorized Signature:
TO'S�Jdd LSSTPEOGOS 60:92 S00Z 9T HSd
FEB 16 2005 13:57 FR TO 3241567 P.01/02
PrgiectNumber: 05000500 Inv: 1 ! Application Date: 02/16/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Permit Use: SINGLE WILE MOBILE HOME 11OR Contact: IIAIUUSON,DAVID
DEPENDENT RELATIVE(TUDR-03-04) Address: 12208 E PORTLAND AVE
C-S-Z: SPOKANE VALLEY,WA 99216
Setbacks:Front 59 L9ft: 15 Right EX Rear: 20 Phone: (509)747-7396
Group Name;
ite ittfPrmation: Project Name:
Plat Key: 001038 Name: GRA.NDVIEW ACRES District: Nort
Parcel Number: 45044.0507 Block: Lot:
SiteAd&ess: 12208 E PORTLAND AVE Owner:Name: HARRISON,DAVID
Address; 12208 E PORTLAND AVE
Location::CSV SPOKANE VALLEY,WA 99216
Zoning: AGR
Water District; Hold: n
Area: 1.001 Acres Width: 0 Depth: 0 Right Of Way(ft): 40
Nbr of Bldgs: 1 Nbr of Dwellings: 2
Review
Site Plan Review Mtge Yr
•
Plan Review j<6jt6 r ,,:
•.�.. 11�,y h yet yk 1.7,4 egu1+ wa: �.r ('tl.I rl '41
Special TIiB tions /A�`V�, I .3'•` .r _.._-Y ".....,.�_,.-�_._....�,- `.r
l� �
•
Septic System Review
z
Permits:
Operator: KC Printed By: K C ; Print Date: 02/16/2005
TM/TM 7nk-1,� SHS QHeIS L9STV3E60S 30:9T S003/9T/33
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Department of Labor&Industries MANUFArCTURED/MO7BILE HOME
Factory Assembled Structures Section `sT"" Q ALTERATION ERATION PED Iw IIT
,� x, l�lrli 1
1 m
INSTRUCTIONS: ," � � P'� r �`� `� . , ,�
Do not .: s
1. Complete all spaces,including the signature box(marked with an X). '
complete voice zs a
2. Draw a.map on reverse side of W.HITE:copy only. �, c k + .
shaded 1 )t.
3 Forward:'completed'permit and fees to the nearest L&I office. See list on reverse. areas
4 Contact and schedule the nspectrpn(s)with the same L&I office'per the checklist. .H ",t
.
Owner name 5 • fvsrnap Dai ttme.phone Date
�'49 � ei 02(23 """`r
Co ' .*' s - .- ..;.1%9' .,.‹; (,?,474- 95"e;),"7- -a
State ZIP
Installer/Contractor/Dealer Phone `"`" Contractor's registration num
J �, ( )
City ZI
i�.; State P+4 V
' 1 `t 7 , ;'-4 .fit I' -L-e,� ]' ,`
" Serial Number(s). H Number(s) w ?lull
- c9;9:c < y0.i` 3 c i r1� iir `
ace feg, nt ti
np , r b0,,,x;',.,,.,,,;,•-44,,,;....4.: 4 wi §y Place feg amo gin prgperbo ' t._., y :,* r .,i.I Mechanical Electrical _Heat Pump.
Air Conditioning Heat pump
Furnace Installation(gas or electric). Air Conditioner
Gas Piping' Furnace Installation(gas or electric)
Wood Stove �. � 4 1V 52. " ' Wood Stove(if applicable)
Pellet Stove ---- `"
Pellet Stove(if applicable)
Gas Room Heater Gas Room Heater
Gas Decorative Appliance(if applicable) '
Gas:.Decorative Appliance PP
Range:changing from electric to gas • Range:changing from gas to electric `
Gas:Water Heater`replacement
r. Electric Water Heater replacement
!<Water Heater:changing from electric togas., _
Electric.Water Heater replacmg Gas Water Heater
Plumbing < Each added or modified ctrcutt:..
Fire sprinkler system(also`requires a plan review).
= Hot Tub':or Spa'(power from home electrical panel)
.j
Each added fixture
Replace main electrical panell
Replacement of water piping system Low Voltage Fire%Intrusion Alarm
Fire Safety
Structural
1111 Inspection as part of a mechanical installation t ; '�a t
(cut truss/floor joist,sheet rocking) Miscellaneous '-'-''...t.'t� + T- 1 ''
Reroofs(may require a plan review) Plan review ' t 'I``3?
Changes to home when additions bear loads on home per ~`'- Reinspection r , _, ; '
the design of a professional(also requires;a. lanreview.l _® _Insignia ,:.. ;4
. ' 'IN ,Other structural changes(may require a plan review) r�
Fire Safety
N : This permit expires one year after date of purchase. (Non-refundable) '-
LWork is completed at this time. An inspection is requested.
Work is NOT completed at this time,I will call when ready. . .
4. ' r-.3622..?
Make check payable to: Dept.of Labor&Industries a Atri
Lice?, §ignaturegf ican or authorized rep�en _ ,• \
FEES DUE '$ ;, 7 X ' ,;'•A -=
b 9 f .¢s! ®:, 4 - } '; .P S 44; E f. f F } x# f 6 '£ f '£ B 3 ''' £
k«e iia ce� o. ti }� x
1 � 4` CI � a e E a ce f r i s ,� s ce f a s . s f s r " art ,; •
' a klCi6* <pe t t` ap + . 2 C 4 v)olat Mated al k'vmypt� f �t i f kf e ; nt
•fix," u` � � c
.viv
< - ,$. -§ ,l ♦ yid��� � f
9? �d 0 k'Bo:` k7 :p k 7. [p wE-8 ® } .� •:. ^X' 3 5.
i Total pages ligi
E27 000 mfgd/mobile home alteration permit 7-02 . white-Olympia Canary-In pector G r en-Contractor Pink-Purchaser- Goldenrod-Purchaser.
Contractor ....:vre....,---57.,.-. .
Le:al Description/of Propert• (Give_complete desdription 4rom deed, tax receipt, etc.) 77_,,,IL. / 5" Cl 7
/
, .... .
. - .
. . _
. . . 5
' DESCRIPTION OF WORK:New.—Addition 1------- Remodel. Moving Bldg,Zone ) Fire Zone.
Size of Lot I .5....Y ) '5" 6 . .. ......._....... .. . ...., Sewage System Stories f
• • • Const, • DimensiOns / .0 '.,q / Total Sq. Ft, / ? Valuation 510 0 —
• (Frame,concrete,brick, etc.)
.. /—•
Rooms_____Baths__I..Basement Foundation Const. e-4'-'-'1'r:.•-•,•' (-)L•• Chimney Fireplace
(Full, part, none),. ••-) ' (Kind) • • (Number)
. .
Heat, System Type of Roofing ---- •••••-••• xt, Finish Int, Wall Finish . f•S'•'', .;",:..,.•
. Use of Bldg, (-2.44,... ...,,ra•--,/ / •; 2,-, rEtr,_ .,,,,,,, Ao.,-,..,-,<, ) No. of Units Bedrooms
parage.ot Carport Atteche.d------------ • --,. Private Detetched
•
. . .
PLOT. . , •
. . . '
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of,sewage sYs^
t-ot and waterup y linespis. g t_Jr
..., ,
• .-ifficpxyomq, Nor ..
Ste License:No,
t , .151 igtisjj, .
• , . •.
•
Ind, InsAcc
t,. N..o, ••..:
f .° 4
. '•l'
•
(--->"------- REQUIRED ' . .
Plumbing Permit
• :-• `I :
1 .
. tI‘t• . .• 'V
2.,
• ' •N —.
• m )i. Heating Permit -
-,
Aik q. ' it,:' ' . ,,.. ,, . ,.„...'"c),,, Sewage Permit • :
- ..4--", , i.4... I i•••`...-.- • . •-.,„ , , .
X t/ 3 i co, .1 T_
,
_ • Li •
• 1 4.1'9 'it.,oh. il . hjC4::' 1 . Plan.s Received
• '
\ .1),•-•-e, - JR,. •1 i
. ''._I - -,---,)t le. 1., V.) <at, •
- , , C Plans Checked
. '1' • _.--,--- - '51'
. 1, "----.
•
15'10.
Plans Returned
-
- • ,5°V717?-F\ ';1''''" -- SI/ - . . - ' Plans Picked Up
' 0" -• si'IV? 11$7124, , _ _, . ,\
Plans Mailed
•
• k , Qi " .. '; -.•9
. ,•\..• SOUTH ' 1127 51' •
. • •
I hereby certify information submitted is correct.and ere are no other structures located on this property exceP
as shown./2 .--) , •
• (
- • • . Owner or Agent Date
. . .., lire "ND crolirTIION PFDLIIT MUST BE 0.N THE PREMISES BEFORE CONSTRUCTION COMMENCES.