2003, 01-10 Permit App: 03000197 MH Project Number: 03000197 Inv: / Application Date: 1/10/2003 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW DOUBLE WIDE MANUFACTURED HOME Contact: OPFER,GUS
Address: 425 S VAN MARTER
C -S -Z: SPOKANE,WA 99206
Setbacks: Front Left: 35 Right: Rear: Phone: (509) 926-4325
Group Name:
Site Information: Project Name:
Plat Key: 001839 Name: OPPORTUNITY TR#01-354 District: F
Parcel Number: 45201.0904 Block: Lot:
SiteAddress: 10504 E 4TH AVE Owner:Name: OPFER,GUS
SPOKANE,WA 99206 Address: 425 S VAN MARTER
Location::SPO ,. SPOKANE,WA 99206
Zoning: UR-3.5 Urban Residential 3.5 4.4
Water District: Hold: ❑
Area: .00 Acres Width: 145 Depth: 330 Right Of Way(ft): 60
Nbr of Bldgs: 3 Nbr of Dwellings: V'
Review Information:
Review111111
_
Site Plan Review Released B : Elf* a-
Plan
Plan Review f` Released By:
+6 low e-? t AL Si-ts,
1 - 16
Landuse/Zoning C.�' DReleased By:
Sewer Review OLIO 'Released By.
(16 1 `� ?)
Permits:
Operator: JAS Printed By: JAS Print Date: 1/10/2003
Project Number: 03000197 Inv: 1 Apphcati n ► Date: 1/10/2003 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Manufactured Home -
Contractor: OWNER Firm: OWNER
Phone:
Item Description Units Unit Desc Fee Amount
INSPECTION FEE 2 SECTIONS $100.00
COUNTY SURCHARGE 1 Y OR BLANK $22.00
INVESTIGATION FEE 2 SECTIONS $100.00
Permit Total Fees: $222.00
STOP WORK ORDER ISSUED BY D. HOWARD FOR A NEW DOUBLEWIDE MOBILE HOME
INSTALLED WITHOUT A PERMIT(2ND RESIDENCE)BY HOMEOWNER. INVESTIGATION
FEES REQUIRED.
D. TRUAX
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Manufactured Home $222.00 $222.00 $0.00 $222.00
$222.00 $222.00 $0.00 $222.00
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: JAS Printed By: JAS Print Date: 1/10/2003
i PROJECT APPLICATION WORK SHEET
211,111k SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,`WDA 99260
509-477-3675
SPOKANE Covury
SPECIFIC SITE INFORMATION
NI' Street Address: / ,�oy <C
` Assessor's Tax Parcel Number(s):
t Legal Description:
r Project Description: C uAk \. ) \1as, `���t (\ � C (,t Y cC OC U- -(._
in Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
t ❑ Relocation El Sign ❑ Tenant(New/Change) ❑ Other
Department Use Only
Water District/Purveyor. Sewer District/Purveyor. Road width Setbacks
Front Rear:
School District Fire District Zoning
f. /� • S Left Right:
OWNER/APPLICANT INFORMATION
El Indieute ubo should be contacted regarding this project
❑ Owner: Phone ��((� �❑ Applicant Phone:
C-- ./.� C. - O `� I as: v1� I•as:
Mailing Address: Mailing Address:
City,State,Zip Citi,State,Zip
`�\i ❑ Contractor 1 Phone ❑ Architect:Engineer Phone
?� r),V /Y C0�,'Y • lax I ax
'. Nailing address Mailing address
c yr _A , 4/l,j Ck. j V-e__.,
Cin,State tip Cin-,State Zip
\\.A State Contractor license# Contact name:
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
Dimensions Total habitable space 2"d floor sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of project I teat source(electric,gas,etc.)
Manufactured Home Sign
Width:\,‘
length: What is t!e square footage of the sign I low high is the sign?
�� facer
Year: A ake: #of signs Area of existing signs
Q, 0 —, u, o E-- .c-
.
Relocation Fire Safety
Previous address Fire Sprinkler Tent
Paint booth lire Alarm fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
Iinn Name Phone Plans Examiner Phone
Inspectors: Address
Inspector Phone
O Concrete O Welding O Bolting O Reinforcement ' Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? Yes O No What is the current property size?
If yes,idents on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If ,identfr on site plan O Yes pi No
Is your property in a designated wildlife habitat area?0�,( Will the site be served by a septic system?O Yes O No
O Don't know O Yes No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
If yes,identify on site plan If yes,identify on the site plan O Yes O No
O Maybe O Don't know O Yes No
Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property?
If yes,identffy on site plan O Yes \471, No O Yes O No
;Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) :Are critical or hazardous materials used or stored on site?
( /°'s) O Yes l® No O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? Yes O No
O-Yes No
Is the property inside the ASA? es O No Is public water available to the site? Yes O No
Yes O No
Is the property inside the PSSA? Yes O No Is the pro located within 1000 feet of a Natural Resource Area?
O Yes pro
Date Rccciccd: Staff Rcprescnta.—
J. . 16
- O Q 4r ill
METHOD OF PAYMENT
00t4 3, SUB l O'1':Al.
VISA
❑ C:ASI I ❑ c [ :ch 0 0 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DAT]?: EXPIRES: TOTAL FEE
BANKCARD NUMBER: MINIMUM PERMIT FEE IS$35.00PLKSSE
MAKE CHECKS PAYABLE 10 SPOKANE
An]IORI''/.I:D SIGN:Al URI:: COUNTY PERMIT CENTER
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