1995, 08-25 Permit App: 95006673 MHPROJECT NUMBER= 95006673
******
2PPLIC;ATION
DATE= 08/25/95 PAGE= 01
THIS IS NO' A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 2913 N RIVISTA DR PARCEL#= 55071.0603
ADDRESS= OTIS ORCHARDS WA 99027
PERMIT USE= DOUBLE WIDE MOBILE HOME
PLAT#= 002265 PLAT NAME= RIVERVIEW MOBILE HOME SUB.
BLOCK= 4 LOT= 3 ZONE= UR -7 DIST#= G
AREA= F/A= F WIDTH= DEPTH= R/W= 50
# OF BLDGS= # DWELLINGS= 1 WATER DIST =
OWNER= BLACKBURN, BOB
STREET= 2913 N RIVISTA DR
ADDRESS= OTIS ORCHARDS WA 99027
PHONE= 509 922 8187
CONTACT NAME= TROY AUSTIN PHONE NUMBER= 509 928 3003
BUILDING SETBACKS: FRONT= 38 LEFT= 6 RIGHT= 17 REAR= 20
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING SETBACK REVIEW REQUIRED
COMMENTS:
( tc-czn g • 2S -95
HEALTHDIST INCREASE IN LOT COVERAGE
COMMENTS: 54 ,Q,5 / Q S-
ct<>)cl_rms
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER
PHONE=
YR/MAKE= 1995 NASHUA MODEL=
SERIAL#= WIDTH= 26 LENGTH= 42 HEIGHT= 10
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 18.00
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 122.50 .00 122.50
122.50
PROCESSED BY: CAROL FRAZIER
PRINTED BY: CAROL FRAZIER
.00 122.50
PROJECT NUMBER= 95006673 APPLICATIC
DATE= 08/25/95 PAGE= 02
******************************** THANK YOU ************************************
APPLICATrON -INFORMATION
What is the JOB SITE address?
)q/.3 0v. �� ��' st vet .
Legal description as it appears on the roperty deed
ASSESSOR'S tax parcel number?
,7eb2 7
l ie ,5-4),‘.04V/;s'/o,v 7&f �a�• polar"
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(rhe • ot- z_ co rico k'/ 9 • 01F,/c� , p�G �,e. >4r o,
WNER or OC UPANT
Phone �
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/al 467aW4.-tn
Mailing address City, state
9./..? ,4< ee'//sus% 13,t - 0-r‘ a'- f'; dx'4 'f 7
Who should we contact regarding this project? Phone
1717°Y , qcs' T/,v mal,/:+ Cf-rr)1/ `/v,,--c°.r
What work is being done under this permit?
zip
Buildin
Contractor
Building height
# of stories
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Mailing address
2nd -floor area
Architect/Engineer
Garage area
Unfinished basement area
Finished basement area
Size of decks, etc.
What is the heat source?.
What is the cost of your project?
Manufactured H0
sign
Width:
Length:
What is the square footage of
the sign face?
How high is the eign7
Year:
/!f
l! 9iJ^
Installer//G
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
/3190aeS�' :�'--s_ _ * ff 7
Relocation`<:
Previous address
Mailing address
Fire Sprinkler _
Paint booth _ Fire Alarm _
Tent
Fireworks display _
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
Fuel Storage Tanks
(Circle one) Above -ground
Swimming Pool
Underground
Contents of tank(s)
Size / gallons
Size / gallons
Private
Public/semi-private
N
V7
4-
t1
d
Contractor
Contractor
Wa State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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INCLUDE THE FOLLOWING:
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❑ All roadways, driveways & easments 0 Underground utilities
❑ Distances from center of roads, right of ways, 0 North arrow
private roads & property lines 0 Septic tanks & wells
O All existing & proposed buildings
A
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WASHINGTON STATE
COMMWLITt TuND
ICONOMIC DEVELOP1AENT
'Mang Foundations for the Future