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2003, 09-29 Permit App: BLD-03-02620 MH
Spokane �,,.•� Valley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 MANUFACTURED HOME Job Address: 11412E 4TH AVE SPOKANE WA 99212 Description: DOUBLE WIDE MANUFACTURED HOME PLACEMENT Subdivision: Owner: Applicant: Address: Contractor: Address: MCWHITE, JOHN MCWHITE, JOHN 419 N REES RD SPOKANE, WA 99216-2069 H & S CONSTRUCTION 11817 E VALLEYWAY AVE SPOKANE WA 99206-5128 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Application #: BLD -03-02620 Applied: Issued: Expires: Lot: Blk: Parcel No: 45212.0927 Phone: (509) 893-1470 Phone: Lic No: (509) 926-8964 HSCON**123KF Zoning: 09/29/2003 03/27/2004 General Information: SECTIONS YEAR BUILT DIMENSIONS # OF BEDROOMS FRONT SETBACK LEFT SETBACK MANUFACTURER 2w 1998 24 X 44 3 36 10 FLEETWOOD Fees: PER SECTION FEE Total Calculated: Deposits/Receipts: Total Due: 100.00 100.00 0.00 CITY OF SPOKANE VALLEY APPROVED FOR SUBMITTAL initials / Data Building Planning 22114/ Public Works 100.00 11Avetic 9'1)0 /SCJ • UO sc.i.txuL. Livitcaxicada Nati- THIS IS NOT A RECEIPT �1, jValley e` ' - gfoo ,0 0 PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 99707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone: (509 688-0036 Fax: 509 688-0037 REQUIRED S TES INFORMATION F��� a 4 tJ Ada- - r Cli k --"r," �� ✓ �� L STREET ADDRESS: 1� A-gir If 4 143-2-/ ASSESSOR'S TAX PARCEL NUMBER(S):p(�`(J � / 2 , cq a 7 LEGAL DISCRIPTION: ®I / o "TN "4-17 7 I JA- 0 z c f tic-- /oat 4u,° h°4 -S gsl2ri0&62 3K 6«r 64 n/27/ �Pc— PERMIT DESCRIPTION: M 0 (S i - (--OAC 13 BUILDING PERMIT []RELOCATION • f}SIGN CHANGE .IN.USE 7 GRADING ® MANUFACTURED HOME ]TENANT(BOTHER 606 1 14ez Wool OWNER / APPLIbANT INFORMATION OWNER'E: �v0 I t W L'bri t- rV l M I APPLICANT: S ©L I M G (( I q PHON• ( -' / © FAX: PHONE: P9 a FAX: pC ,',-//�//7� ,Q , / (� r Q '` ADDRESS: / 2 l� 2 i- J . ADDRESS: T / 1./- i fl rj i r U 9 V 'v !AIL1 `'Z l9 Z poky, `/ GI7y ATE, -ZIP • CITY, STATE, IP CONTRACTOR: S Co/t''4T tUGT, a/1/ a ARCHITECT.: PHONE: Si/r 2 6 -r 0 6 �( FAX: PHONE: FAX: ADDRESS: 1- 11 Eq/ 7 V l?'(/L61 441 ADDRESS: S P•(�T, f:-__ Ifl-u- , - A14* GI � TY jATE ZIP CITY, STATE, ZIP WA ST CONTRACTOR LICENSE �1- S_ •LoN - I l '• 4IL CONTACT: �I PERMIT/BUILgING INFORMATION COST OF PROJECT: 30% SLOPES N PROPERTY: BUILDING HEIGHT TO PEAK: OCCUPANCY ROUP:. BUILDING DIMENSIONS: CONSTRUCT! N TYPE: NUMBER OF STORIES: STRUCTURES CRITICAL ARE CURRENT PRC NUMBER of BEDROOMS: FLANKING SETBACK: FRONT SETBACK: CURRENT PROPERTY USE: DECK: REAR SETBACK: CURRENT SEPIIIIC USE: LEFT SETBACK: CURRENT WELIIL USE: RIGHT SETBACK: IMPERVIOUS SURFACE AREA: JN PROPERTY: S: PERTY PERTY SIZE: MAIN FLOOR SQ FT: 2N0 FLOOR SQ FT: UNFIN BASEMENT: FINISHED BASEMENT: GARAGE: COVERED DECK: MANUFACTURED HOME SIGN WIDTH: —1 LENGTH: Lk,y YEAR: P, IT SET: 'A/ MANUFACTURER: �CSlQ-— SQ FT OF SIGN: HEIGHT OP SIGN: # OF SIGNS: AREA OF EXIST SIGN: TYPE OF SIGN: RELOCATION FIRE SAFETY 1 PREVIOUS ADDRESS: PROPOSED USE: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: FIREWORKS DISPLAY: BLASTING: DATE/TIME: WA STATE NON-RESIDENTIAL ENERGY CODE PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY, STATE, ZIP INSPECTOR: PHONE: FAX: ADDRESS: are, STATE, ZIP O BOLTING FIRM NAME: INSPECTOR(S): El CONCRETE REINFORCEMENT PHONE: o WELDING FAX: IS PUBLIC SEWER AVAILABLE: 1 YES 0. NO 13 IS PUBLIC WATER AVAILABLE: ▪ YES NO IF YES: ▪ COUNTY o CITY IF YES, WHICH WATER DIST/IRR. IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO PSSA: 0 YES 0 NO DATE: I STAFF: METHOD OF PAYMENT: O 0 a CASH CHECK I VISA BANKCARDA;• EXPIRES: VIN # AUTHORIZED SIGNATURE. *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD Department of Labor & Industries MANUFACTURED/MOBILE HOME factory Assembled Smmtures Section j{!l�y INSTRUCTIONS: .1. Complete all spaces, Including the signature box (marked with 2. Draw a ma onreverse side of WHITE co onl P copy Y• 3.. Forward completed permit and fees to the nearest L&I office. P e 4. Co to tan h dyle the inspection(s) with the same L&I offl ,'ryer !' �^ .J.%•l‘d ALTERATION Do not n X). complete ee list on reverse. areas `areas per the checklist PERMIT �>a:; `JSw._...` ,\...`"',,...$iigq:`SixStias:"".;.:�?`.%', a,. '•. i :?? ,i‘..b $° a J. .in ♦,`ci ag 3 3Y&`i..: ,' z:tom\,' ;'�'<.':•'�s an �`.� � r ��. "" \ \`�"t: ?'aa?'>>sY�'�Jq,,9:�%�Wy x< \:>42:ki:.:a.�`,:n�•\.Fak>J\'�,i..�:4:�W:S`SJrvsQ.'nh»,�i>,„�tx'+:. i9'>a] Owner last tame first name Address =-. `il c�• I` -,f l:. 1. f I.) Day time phone ( ) City / i....9 .,t, fId1, £v Date State ZIP i- )c) fit Installer/Contractor/Dealer Address Phone ( ) City Contractors registration number State ZIP+4 Seri r(4) -\ r •• . ? f ; . t t 7 HUD Number(s) Place fee amount in proper box Mechanical Heat Pumip (gas or electric) " • lace home pe plan revie ) fee amount In proper box Electrical Heat pump aPpge applicit App) frot Heater Heater modified (power electrical of.lrt-e-r t V 1� t t kas'tb`el replacement replacing circuit from panel Fu)x K .r.bo('- fy r:r"..,,,r,, it, . ilh}27 J+a9 f�5 t r(if` RA e) we - Gas Water Heater home electrical panel) Z Alarm p U w Z Air Conditioning Furnace Installation Air Conditioner Gas Piping Furnace Installationl Wood Stove Ssri < Wood Stove (if Pellet Stove Srrat Pellet Stove (if Gas Room Heater Gas Room Heater from electric to gas replacement from electric to gas (also requires a plan review) piping system of amechanical installation joist, sheet rocking) a plan review) when additions bear loads on professional (also requires a (may require a plan review) Gas Decorative Appliance Gas Decorative Range: changing Range: changing Gas Water Heater Electric Water Water Heater: changing Electric Water Plumbing Fire sprinkler system Each added or Hot Tub or Spa Each added fixture Replace main Low Voltage Fire/Intrusion Replacement of water Fire Safety Miscellaneous Plan review Structural Inspection as part (cut truss/floor Reroofs (may require Changes to home 'Reinspection - OngtpalPerinur - Ori <;n O the design of a Other structural changes Insigni s.t.,ter 1' v f Other ] rea.D+c Fire Safety N Note: This permit expires one year after date of purchase. (Non-refundable) HWork is completed at this time. An inspection is requested Work is NOT completed at this time, I will call when read . M J Q Make check payable to; Dept of Labor dustries FEES DUE $ , --1U Srgnittu o a t for authon re res µLe Cg g t ? sbA u$ sS cwl� Qla ao t�� �sli; to1`iile and it�a Id s, or II:. mals e eonect an nspecdtontreques d whhrrt 0 da$'''' henotice To Ito date Failureto comply `^S\ �^ es tut• , e \9 \ $va\ii tee 24. 'two i @ ha y` A>,'�aF`'\O\` .49., ( pjy tkStllt 1 � ll t�#� � M4X 1 bid# $gra et tr ha R \ ►tzn ftet• iiii ctoc erob br ,:on f u tlotrForm "fib's»n ?n% xt�k,,%\4t :`.n4\c> <G2C`\'i\�y ��,' �WJ.` `b� .0 a'< la �`L$ kk �\'> -'.l.,, ,. ., ,., .4. y�\. `4Yv:'...,\:'?.>\ tJ,i,�+i�. i.. `. $<`t<F 'j %``.`b, >. 4..n ti%.il.4:,.w.SJ?;4%. \C.,,'..:J %..?k,. ro`%\4dt,..q•R.w:>...b , ..i.,. 4 p2pL,. ,n n�$�b. .[Y,�'.�C,:obn.0 :.�,. v„ ,'.».J. '♦ .oY.'b.,`b:, anN '<\\, `d:, ,nU.."M`H>:,: b!%:�a,,'`... '': x.p�.y...{4:: >A+$' C[i. i\.n. .t,0? .. .J..P,ie k,?`$ R.. „V ,4. .3n\'4:$,<b:4:H�n �4.. .'`C... � R4., .,.. .. .. . ia,.. �: ;. ,; $,. �.,,'j4:`�"Y0.:. �,. .,:?,a..�. t,.,.ro`:"`.`'`'`�'4'[k.,F�,..:,hG\oas�R.>.!qr�..,.:[�<""vgmv:',�,'t, .�.v :§>�ek...£,4J.n.. `3\'� @>,,vie .�. t. . §<4.➢.,. .ye�§,.,?. w\`Zen ,_s:.;u . ...:.`sb.>:.D .n .o. .^, x. `...i . '••• .v;>.4,. ,n\., �, \.:J ,:<\.. ,.<.:C . `%4 k, m.J.. [,.uC� k„'C:b.� v'n ..i�§:'k.\:::Rh';N:R)4:?:,.`;:>:.vv..::':?A. >,•••••, aika' %,.�:,:..,:>..[:,V.�,`.: q<...,. ,Y >., i:; �k,.4.. ..,o[nn,§: i\\QY��`$� #,W. �L.�,>.S A`�'§� \i`5 %4, �', b �'t b' $ F\ • i4£h n,a`,�, £ 4� yb5.t, §.�V e><T,t k C3\ 7: \i",h,t\ N9r \ ` 2 '.t, ,, $,,t'4\'\`Y,: $\\\,�<�n�`�L)`4,Z��,7J £,.t�S`\>�W 4�C'\`�T� �`}�C�k S�'.:%•t%\�,,�\�R;Z�A ��bb'%�.\<%C.i�' �•F` e\. '>.:. �,,,>.'?T[\`,�``,4§>:`\.�\kC%A�t.>\i tr w 2 Z QWffi itt Z f Z WO J ♦ - 1/) W 1- 0- < a¢ F622-036-000 mfgd/mobile home alteration permit 11-02 White-Oly pia Canary -Inspector Green -Contractor Pink -Purchaser Goldenrod -Purchaser Oct 02 03 08:46p HS Construction SPOKANE COUNT AND COD 1026 West' BROADWAY A Site Information 509 928 3406 p.1 Y DIVISION OF BUILDING ENFORCEMENT VENUE • SPOKANE, WA 99260-0050 Project Information Site Address: 11412 E 4TH AVE SPOKANE, WA 00000 Parcel Number: 452110927 Subdivision: Block: Lot: Zoning: UNK Unknown Owner: MCWHITE, JOHN Address: 11412 E4THAVE SPOKANE, WA 99216-1324 Building Inspector. BOBBY STONE Water Dist Project Number: 03007156 Inv: 1 Issue Date: 10/2/2003 Permit Use: SEWER CONNECTION - WOODLAWN Applicant H & S CONSTRUCTION 11817 E. VALLEYWAY AVE SPOKANE WA 99206 Contact: FI & S CONSTRUCTION 11817 E. VALLEYWAYAVE SPOKANE WA 99206 Phone: (509)9264964 Phone: (509) 926-8964 Setbacks -Front: Left: Right: Rear: Group Name: Project Name: I Permi's Sewer Connection Permit Contractor: H & S CONSTRUCTIOT pease #: BSCON.923KF SEWER CONNECTION 1 885.00 PROCESSING FEE Total Permit Fee: FOR SEWER INSPECTIONS CALL (509) 477-3604 UTILITIES :30-5:00 PM MONDAY THRU FRIDAY Call for inspection prior to coves. ONE WORKING DAY NOTICE UIRED. Contractor or applicant is to field locate and confirm the elevation position of sewer stub prior to any other excavation. Sewer stubs arc to be checked prior to connection to ensure that they hate acceptable grade and are clear and unobstructed to the main sewer. Sewer lints should be constructed to allow for gravity flow from the owoel level of the structure. This permit must be presented to the job site inspector for vcfrealio . To locate buried cables, gas piping, water lines, etc. CALL BEFORE YOU DIG, (509)456-8000. STATE LAW RCW 19.122 REQUIRES THAT PRIOR TO ANY CAVATION THE "CALL BEFORE YOU DIG" CENTER BE NO 111.16D. CALL BEFORE YOU 13I0 AT LEAST 2 WORKING DAYS IN ADVANCE, (509)456.8000. Spokane County Code requires the installer comply with all rcquircn ants of the Washington State Dept of Labor and Industries, including those related to trench safety. $15.00 5100.00 Payment Summary Total Fees AmountPaid AmountOwine 6100.00 5100.00 $0.00 Processed By: BURRIS, ROBIN Printed By: WENDEL, GLORIA Trail Date 10 Receipt # Payment Amt 003 6290 5100.00 Page 11 of 1 PERMIT 87 77 0.98 -4/6--R/R e.?; 24. 00 A (' 2790 MOBIE HOME 1A.A4 36 00 1.1U