2006, 11-07 Permit App: 06004439 MH Project Number: 06004439 Inv: 1 Application Date: 11/7/2006 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
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Permit Use: REPLACE SINGLE WIDE WITH 27X70 MFH Contact: HOME BOYS
Address: 14525 N NEWPORT HWY
C-S-Z: MEAD,WA 99021
Setbacks:Front Left: Right: Rear: Phone: (509)468-1750
Group Name:
Site Information: Project Name:
Plat Key: 002208 Name: RETTIG ADD District: E
Parcel Number: 45202.1403 Block: Lot:
SiteAddress: 614 S WOODRUFF RD Owner:Name: ANGELERI,EVELYN
Address: 614 S WOODRUFF RD
Location::CSV SPOKANE VALLEY,WA 99206
Zoning: AGSUB
Water District: Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review
Flood Plain Released y:
Building Plan Review Released 14 -
Driveway/Approach Released By:
Landuse/Zoning/HE Conditions Released By. ", r /1ta7
Sewer Review Released By:
Operator: AMB Printed By: AMB Print Date: 11/7/2006
Project Number: 06004439 Inv: 1 Application Date: 11/7/2006 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Manufactured Home
Contractor: HOMEBOYS Firm: HOMEBOYS
Address: 14525 N NEWPORT HWY Phone: (509)468-1750
MEAD,WA 99021
Item Description Units Unit Desc Fee Amount
INSPECTION FEE 2 #SECTIONS $100.00
Permit Total Fees: $100.00
Payment Summary: „ m � mvm�ma� •h�.� .taum .nom �dak ..arn, �, a„ .,,� �p «��
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Manufactured Home $100.00 $100.00 $0.00 $100.00
$100.00 $100.00 $0.00 $100.00
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: AMB Printed By: AMB Print Date: 11/7/2006
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City of ; "' 1
SPOKANE VALLEY ' - I�� ht L�) (� c
PERMIT #
BUILDING PERMIT APPLICATION
Box 1 OWNER eV E -$4, A L L E-2 I JOB LOCATION 6:34 S . WOO D f2-%—
OWNER'S ADDRESS .E CITY$?Vital PHONE 38e?-o 43 I
DESCRIBE JOB ZE t Pr -E. 114* 10 'v4vi' w/ Z 7 X?O pA,4'
THIS PROPERTY IS OWNED B ARRIED
PARTNERSHIP COR .
BOX 2 CONTRACTORS NAME 4-6 nvA�gOtt5 PHONE 40?- n SD
CONTRACTOR'S ADDRESS 14SLS LL at4,0- CITY rIL.C.26%--D l OZ-I
CONTRACTOR'S REG.# 4-67 N4..6 •Os 3-rc EXPIRATION DATE 4\:::, 7
(CARD MUST BE PRESENTED AND COPIED O VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT 1 Q -J LS L3t-.71 PHONE x'139" )
ADDRESS Pig- PCS CCN ZIP
BOX 4 SEWER AVAILABILITY `{,*S WATER AVAILABILITY 9 b,S.
BOX 5 ESTIMATED PROJECT COST$ X3.000 EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER 4S?AZ. . 1 '403
LEGAL DESCRIPTION
"e (4 AriN6 Lo-r 3 —61.1 ,.
X -ri '‘-k-)et,- a `'�'I�*�l rte; ,.
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing/ proposed) 1ST FLOOR 14 !Q AI 2ND FLOOR --/----
3RD FLOOR ---7—" OTHER /--- BASEMENT FINISHED —7--
BASEMENT UNFINISHED 'w"--7—' DECKSXS / IO XVI GARAGE EVIS J
CARPORT —"T" TOTAL ---/ HEIGHT TO PEAK OF BUILDING I Z. FT.
BOX 8 X) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/ INDUSTRIAL TOTAL AREA OF PROPERTY I2..1000 SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough-ins) MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
BOX 10 Water Service meter size(if known) /a 5 f Also see BOX 4
BOX 11 i
, Septic Tank–Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERFORM THE �WORKRKFOR WHICH THE APPLICATION IS MADE.
OWNER/AGENT 1iA'V i 1 �rT DATE /�/O /UCS (OVER)
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard Expiration Date
Print the name of the Holder Signature
DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES.
OFFICE USE ONLY- PLEASE DO NOT WRITE BELOW THIS LINE
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
1
PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ALT/ADD NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORIES
BUILDING SQ. FT. @ -
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING PERMIT NO. PLAN CHECK FEE RECD RECEIPT NUMBER
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES AMOUNT DUE
BUILDING DEPARTMENT APPROVAL BY
DATE
ASSIGNED ADDRESS
Received