2004, 04-30 Permit: BLD-04-04239 MH Spot ane
.000.0Valley MANUFACTURED HOME PERMIT
11707 E. Sprague Ave.,Suite 106
Spokane Valley,WA 99206 Permit#: BLD-04-04239
Job Address: 5112 E 4TH AVE Applied: 04/30/2004
SPOKANE VALLEY WA 99212 Issued: 05/05/2004
Description: SINGLE WIDE MOBILE HOME Expires: 11/01/2004
Subdivision: Lot: BIk: Parcel No: Zoning:
Owner: NELSON, DALE
Applicant: NELSON, DALE Phone: (208)664-3713
Address: 1022 4TH ST
COEUR D'ALENE, ID 83814
Contractor: Phone:
Address: Lic No:
General Information: Fees:
SECTIONS 1w PER SECTION FEE 50.00
YEAR BUILT 1974 Total Calculated: 50.00
DIMENSIONS 14 X 66 Deposits/Receipts: 50.00
#OF STORIES 1
FRONT SETBACK 25+ Total Due:
0.00
REAR SETBACK 15
LEFT SETBACK 11'6"
RIGHT SETBACK 10
MANUFACTURER BARRINGTON
Disclaimer:
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. ,
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Pa/e— it',eIS't h. Le L
Print Name ignature Date
Staff Initials
THIS IS NOT A RECEIPT
t ' ) THIS IS NOT A PERMIT
Scarve ,/ Penalties will be assessed for
poise commencing work without a permit
4000' 'Valley MANUFACTURED HOME
11707 E. Sprague Ave., Suite 106
Spokane Valley,WA 99206 Application #: BLD-04-04239
Job Address: 5112 E 4TH AVE Applied: 04/30/2004
SPOKANE VALLEY WA 99212 Issued:
Description: SINGLE WIDE MOBILE HOME Expires: 10/27/2004
Subdivision: Lot: Blk: Parcel No: Zoning:
Owner: NELSON, DALE
Applicant: NELSON, DALE Phone: (208)664-3713
Address: 1022 4TH ST
COEUR D'ALENE, ID 83814
Contractor: Phone:
Address: Lic No:
General Information: Fees:
SECTIONS 1w PER SECTION FEE 50.00
YEAR BUILT 1974 _/ Total Calculated: 50.00
DIMENSIONS 14 X 66
#OF STORIES 1 Deposits/Receipts: 0.00
FRONT SETBACK 25+ Total Due:
50.00
REAR SETBACK 15
LEFT SETBACK 11'6"
RIGHT SETBACK 10
MANUFACTURER BARRINGTON
CITY OF SPOKANE VALLEY
APPROVED FOR SUBMITTAL
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THIS IS NOT A RECEIPT
04/30/2004 14:21 5093241567 SRHD EHS PAGE 01
TO 3241567 P.02iO3
APR 30 2004 15 12 FR ' `
`
THIS 1S N07 A PERMIT
Penalties will be assessed for
1oka11ecommenng Work without a permit
4000011;
V MANUFACTURED HOME
11707 E.Sprague Ave.,Suite 108 ' Application#: BLD-0404239
Spokane Valley,WA 99206 ;
Applied: 04/3011004
Job Address: 5112 E 4TH AVE i Issued:
SPOKANE VALLEY WA 99212 I Issued:
10127!2004
Description: SINGLE WIDE MOBILE HOME
Lot elk:
Parcel No: Zoning:subdivision:
Owner: NELSON,DALE
Phone: � (208)8+x43713
Applicant: NELSON,DALE ,
Address: 1022 4TH ST I,
COEUR D'ALENE,ID 83814 I
Phone:
Contractor: Lic No:
Address:
SECTIONSECTIFees: i
Information: PER SECTION FEE
50.00
1w 1974 � Total Calculated: 50,00
YEAR BUILT 14 X 66 Total
Calculated:
ed 0.00
DIMENSIONS
#OF STORIES 1 � Tote!pus: 50.00
FRONT SETBACKCK1125+
REAR SETBACK
LEFT SETBACK 11'8" I
RIGHT SETBACK 10
MANUFACTURER BARRINGTON
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'CITY OF SPOKANEiVAugy
APPROVED FOR SUMITTAL
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