1997, 03-10 Permit App: 97001279 MH PROJECT NUMBER= 97001279 APPLICATION DATE= 03/10/97 PAGE= 01
PROJECT NUMBER= 97001279 APPLICATION DATE= 03/10/97 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 4820 E 2ND AVE PARCEL#= 35232. 1707
ADDRESS= SPOKANE WA 99212
PERMIT USE= DOUBLE WIDE MOBILE - REPLACEMENT
PLAT#= 002480 PLAT NAME= SPRAGUE STREET ADD
BLOCK= 9 LOT= 102 ZONE= UR-7 DIST#= D
AREA= 00000000 F/A= F WIDTH= 75 DEPTH= 135 R/W= 60
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= AGUILAR, JESUS T. PHONE= 509 535 4843
STREET= 4820 E 2ND AVE
ADDRESS= SPOKANE WA 99212
CONTACT NAME= JESUS AQUILAR PHONE NUMBER= 509 535 4843
BUILDING SETBACKS: FRONT= 35 LEFT= 10 RIGHT= 5 REAR= 76
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING L & I ALTERATION PERMIT
,\SQ_Q (l: `Couck
COMMENTS: pAANA 1-1M9
BUILDING SETBACK REVIEW REQUIRED
COMMENTS: .1 -i 7
HEALTHDIST INCREASE IN LOT COVERAGE Y t'w s1-to S,% wit'C.L d —
COMMENTS: /kw "104//c Ae-c f a/2 L'-d i /i 0 7
PLANNING INADEQUATE FLANKING ST SETBACK j;U'' `e
COMMENTS: `�� t.1 '`t_)c`G{',t (
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER PHONE=
YR/MAKE= 1972 BROOKWOOD MODEL=
SERIAL ;V'ew is aqui(, by Labor and indust riH= 24 LENGTH= 60 HEIGHT= 10
i
;` e2aUou to a manufactured home:
=iii
; Ili 4 Date
PROJECT NUMBER= 97001279 APPLICATION DATE= 03/10/97 PAGE= 02
ITEM DESCRIPTION QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4 .50
COUNTY SURCHARGE Y 22 . 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 126.50 . 00 126.50
126.50 . 00 126.50
*******************************************************************************
* PROJECT NOTE: TOPIC = CONDITIONS DEPT = BUILDING
*******************************************************************************
ALL REQUIREMENTS OF LABOR & INDUSTRIES ALTERATION PERMIT
MUST BE MET PRIOR TO OCCUPANCY OF MOBILE HOME.
PROCESSED BY: CAROL FRAZIER
PRINTED BY: CAROL FRAZIER
******************************** THANK YOU ************************************
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Department of Labor&Industries k r-.) 1 ' ' LiMb
LTERATION PERMIT
Do not complete shaded areas
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INSTRUCTIONS: (Permit# 7 13 3 9 4 1
1. Complete all spaces,including the signature box(marked with an X). Invoice#
2. Draw a map on reverse side of WHITE copy only.
3. Forward completed permit and fee to the nearest L&I office. See list on reverse.
4. Contact and schedule the Inspection with the same L&I office within 15 days. Insignia#
Owner last name first name Day time phone Date
1 O
Address City State ZIP
• Installer/Contractor/Dealer Phone I Contractor's registration number
( ) JI
Address City State ZIP+4
Check the appropriate boxes in section A and section B. FEES
A B ❑ Alteration Inspection(check appropriate boxes below) $75,00
Commercial Coach U Air Conditioning/Heat Pump
Sepal No. • Electricall
'E` ''` hF �Fi & INDUSTRIES
• Electrical Appliances
Li Mobile Home U Fire Safety
Serial No. ® Gas Furnace M A R 10 1997
, ;
II Gas Piping
Hill)No. U Plumbing 1,, i a p
Structural 61_gri. .fiii,, } WA
I
�y LJ
Recreational Vehicle or Park Trailer Wood/Pellet Stove— —
Serial No. Plan Review $70.00
k RV Inspection $70.00
Model No.or Plan Approval No. Reinspection Original Yetmit $50.00
Technical Inspection $50.00/hr
Signature of applicant or authorized representative
e Make check payable to: Dept.of Labor 8z Industries
X FEES DUE $
De artment use only
Request approved or LI Request denied because of specific violations of Washington rules and regulations. Violations
must':be corrected and reinspection requested within 10 days for recreational vehicles and 20 days for mobile homes and
commercial coaches of the notice of violation date. ((This does not apply to technical inspections). It is unlawful to offer for sale,
rent,or lease any non-complying mobile home,commercial coach or recreational vehicle.
C
r Included are forms required which must be completed and fees submitted before reinspection.
1 (Date Area office Inspector )(Total page_
1
F622-012-000 alteration permit 4-96 White-Olympia Green-Contractor Canary-Inspector Pink-Purchaser Goldenrod-Purchaser
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