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2006, 11-20 Permit App: 06004600 MH aT�or Permit Center i / / Spokane 11707 E Sprague Ave, Suite 106-Th' PERMIT NUMBER: &c;�� 1Valle Spokane Valley,WA 99206 '` Nov Z �� g� T FEE: ( Y (509)688-0036 FAX:(509)688=6037 '� Community Development www.spokanevalley.org L_-._'; Il 1\ Manufactured Home Permit Application OTHER SITE ADDRESS: ID I c S. W03LEU1 T ASSESSORS PARCEL NO: LEGAL DESCRIPTION: Building Owner: Contractor: 4 Name: gE. A ,IGAe , Name: Address: /©/6— s LYa a Da 1.0,c Address: City:"S P1 VA A 4E,,,r State:) ,,Ii Zi q j0 et, City: State: Zip: Phone:'A e s Fax: Phone: Fax: Contractor Lic No: Exp Date: Contact Person City Business Lic.No: Name: Phone: Describe the scope of work in detail: MANUFACTURED HOME Width: .2 8 1 Length: ifo / Year: l FieL Pit Set: hi Septic/Sewer: Manufacture: 4, / � ��61-�� � Previous Address: (rt, , Af? C,,,,e7-J ` �+ O.t1 P A + Proposed Use: R F S t 0 E.N 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.6) Plans or additional information may be required to be submitted, and subsequently approved before this application can be processed. Signature '`, 1 ) J. Date Method of Payment: 0 Cash ❑ Check 0 Mastercard ❑ VISA Bankcard#: Expires: VIN#: Authorized Signature: REVISED 6/23/2005 i r , # lip 44( 0., / - ti1 k (•1 tr, I. �_._________ �_._. b �N , „ r72! a or, and I- m o