2005, 07-11 Permit App: 05002345 MH Project Number: 05002345 Inv: 1 Application Date: 07/11/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SINGLE WIDE MANUFACTURED HOME Contact: CRONK,CINDY
REPLACEMENT Address: 19008 E VALLEYWAY AVE
C-S-Z: GREENACRES,WA 99016-9657
Setbacks:Front 25 Left: 10 Right: 25+ Rear: 35 Phone: (208)262-0500
Group Name:
Site Information: Project Name:
Plat Key: Name: RANGE District: East
Parcel Number: 55192.1404 Block: 3 Lot: 4
SiteAddress: 17304 E 4TH AVE Owner:Name: CRONK,CINDY
Address: 19008 E VALLEYWAY AVE
Location::GRE GREENACRES,WA 99016-9657
Zoning: UR-7 Urban Residential-7
Water District: Hold: ❑
Area: 8,393 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Site Plan Review Released By:
Plan Review Released By: G �f
Permits:
Manufactured Home
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
INSPECTION FEE 1 SECTIONS $50.00
Permit Total Fees: $50.00
Operator: K_C Printed By: K_C Print Date: 07/11/2005
Project Number: 05002345 Inv: 1 Application Date: 07/11/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
THIS HOME IS A REPLACEMENT OF AN EXISTING SINGLE WIDE(2 BEDROOM)MOBILE
HOME.MUST MAINTAIN 5 FEET FROM SEPTIC TANK.
See plat file for TURTLE CREEK SOUTH 2ND for special drainage requirements
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Manufactured Home $50.00 $50.00 $0.00 $50.00
$50.00 $50.00 $0.00 $50.00
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: K_C Printed By: K_C Print Date: 07/11/2005
- BUILDING PERMIT APPLICATION WORKSHEET
` Spokane
ylEc -EFIvED
City of Spokane Valley Community Development Department
Building Division
N 11707 E. Sprague Avenue, Suite 106
' '''\'' '' 4000Valle ... i l';;,,-
Spokane Valley, WA 99206
_._
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hone: (509) 688-0036; Fax: (509) 668-0037
-_D i-t -
REQUIRED SITE ! ORMATION
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Street Address: t�7 S o u 6 . ' -6 h Ora res iO4i• Q 9O/ ,
Assessor's Tax Parcel Number(s): qct , DO I R 3
Legal Description:
PERMIT DESCRIPTION -P (rc C - ,C( (t° L�LC�e
1" 7
❑ Building Permit ❑ Change in Use ❑ Grading El Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner. U/lil ( Gm 1 0 Applicant: • •
Phone:200-a�o�f arFax: Phone: Fax:
Address: /7 30C1 F, Address:
City State Zip Code City State Zip Code
0 Contractor: 34 if 1V/ A 0 Architect:
Phone: Fax: Phone: Fax:
yAddress: Address:
City State Zip Code City State Zip Code
• WA State Contractor License#: Contact:
Spokane Valley Bus. Liscense #: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT To _ : DIMENSIONS: #OF STORIES:
MAIN FLOOR TO SQ. FTG: 21\"FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE G: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: RVIOUS SURFACE AREA:
I COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER O' a -SITE SEPTIC
SYSTEM?
MANUFACTURED HOME _ _ .
i
Width: / Length: 70 r 'Year: /Q9 Pit Set:
Manufacturer:
RELOCATION
Previous Address: - ,
Proposed Use: R (c" 7 �a '
L_ FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax:
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING
Firm Name: Phone: Fax:
Inspector(s):
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.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
(1 Cash ❑ Check [I] Mastercard ❑ VISA ❑ Other
Bankcard#: Expires: VIN#:
Authorized Signature:
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This site plan is bean
obtaining a sbg submitted for the
reprenentation building Permit and is a true purpose o f
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1lines of the Proposal, and correct
1R /dimensions,curb g All known Property
have been i,entified nes.structures and easements
bodies of ,." r, ate so indicated •
sto' or other are wetlands,
Signed: e- _ itical areas.
Date: 40P 7 "...,