2012, 01-20 Permit: 11003750 Inspect k Y E-
so
pokane
TY OF
MANUFACTURED HOME INSPECTION RECORD CARD
.000PERMIT #:
Valley OWNER: C>y ,;t --L,,, `tln
ADDRESS: ?j4en, 1�4 v v C
MANUFACTURER MANUF DATE:
MODEL: SERIAL NUMBER:
"HUD" LABEL/STATE LABEL NUMBER: DATA PLATE:
DEALER: DEALER#:
ELECTRICAL-L& I FINAL APPROVAL:
INSTALLER: 8/+ E/I t v .: WAYNES#: z. z se/
INSTALLER: WAYNES#:
INSTALLER: WAYNES#:
INSTALLER: WAYNES#:
INSTALLATION
INSTALLATION #: ANCHOR#:
INSTRUCTIONS UE MANUFACTURER: STATE:
NFPA 225
FOUNDATION: FOUNDATION TO LOCAL BLDG CODE:
SUPPORT: SUPPORT LOCATIONS PER MANUFACTURER OR ENGINEERED DESIGN:
ELEVATION: ELEVATION OF LOWEST FLOOR(IF IN A FLOOD HAZARD AREA):
SUPPORT FOOTINI TYPE: r " A.w u=) ez,ELL f 4
SIZE:
PIERS: MATERIAL 3ACh
SPACING: FA ch .Sf1c3'„
SHIMS: yl5
LOT/SOIL CONDITIONS: ?c i `"
ANCHORS: SPACING: /0'
EQUIPMENT USED: 5tf' V 5
EQUIPMENT APPROVED:
FRAME REMOVED: PERMITED BY MANUFACTURER: v.
(PRIOR TO 11/89)
FOUNDATION TO LOCAL BLDG CODE: r os
SUPPORT LOCATIONS PER MANUFACATURER OR ENGINEERED DESIGN: y, 3
ELEVATION OF LOWEST FLOOR(IF IN A FLOOD HAZARD AREA):
SKIRTING: TYPE: 11t r 64,c f
ATTACHMENT TO HOME: ye>
POLY ON GRADE: ye.)
ACCESS PANEL: y�S /
COMMENTS St„A- � fS iappove d j G.t'IiaJipr c //iveS
*FINAL APPROVAL MEETS THE REQUIREMENTS FOR TITLE ELIMINATION EXCEPT FOR PARK PLACEMENT*
INSPECTOR: .-r DATE/TIME: i/ o/
ORIGINAL COPY:CITY OF SPOKANE VALLEY ADDRESS FILE COPY FOR OWNER