1997, 05-12 Permit App: 97003041 MH PROJECT NUMBER= 97003041 APPLICATION , DATE= 05/12/97 PAGE= 01
PROJECT NUMBER= 97003041 APPLICATION A DATE= 05/12/97 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 17305 E 4TH AVE PARCEL#= 55192 . 1213
ADDRESS= GREENACRES WA 99016
PERMIT USE= EXISTING SINGLE WIDE MANUFACTURED HOME (TITLE ELIMINATION/REPLCM
NT)
PLAT#= 000077 PLAT NAME= APPLE VALLEY ESTATES 1ST ADD.
BLOCK= LOT= ZONE= UR-7 DIST#= G
AREA= 00008640 F/A= F WIDTH= 72 DEPTH= 125 R/W= 50
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = CONSOLIDATED IRRG #1
OWNER= LIGHT, CLEMENT J PHONE= 509 928 3514
STREET= 17305 E 4TH AVE
ADDRESS= GREENACRES WA 99016
CONTACT NAME= CLEM LIGHT PHONE NUMBER= 509 928 3514
BUILDING SETBACKS: FRONT= 25 LEFT= NA RIGHT= 10 REAR= NA
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING SETBACK REVIEW REQUIRED
APPROVAL: REPLACEMENT DATE: 05/12/97
' I i 3 �. ) 4) Sewage s►ttem designed
HEALTHDI T NEW )OR ADD/ TIONAL WASTE WATER fora bedrooms onijr.
COMMENTS: g g�,-?, s G� Z-�/ 111.4 5/1,24
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER PHONE=
YR/MAKE= 1984 GOLDENWEST MODEL=
SERIAL#= WIDTH= 14 LENGTH= 70 HEIGHT= 00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
INSPECTION FEE 1 50.00
COUNTY SURCHARGE Y 11. 00
STATE SURCHARGE Y 4.50
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 65.50 .00 65.50
65.50 .00 65.50
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULIE SHATTO
r
PROJECT NUMBER= 97003041 APPLICATION - DATE= 05/12/97 PAGE= 02
******************************** THANK YOU ************************************
-.-•
)ESCRIPTION OF WORK: New )( _ Addition . _ Remodel Moving �g._Zon
;ize of Lot _ 72' X__ --1Z 1 Sewage System SSTTS '
/ / 7'2,o
stories I Dimensions -VA x 3C> --- ------ Total Sq. Ft.
looms--.L Baths NAT Basement NN ..-Foundation Const. _ ---0N Chimney-.
Full, part, none)
leat. System NA, Type of Roofing 6002031-1700 Ext. Finish 1.2-1 ) i Int. W
l t AC. ,J V --r No. o'
Jse of Bldg. �o�c�.C`xE-' ' � p �'- "-_'
IOADWAY R/W WIDTH _S(�
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines Albd streets; (5) dimensions of buildings:
tern j0 Oand water supply lines. RFS
NORTH 9p S,•
72 1 1:Ty, �a , _.-
0 ,\
/ - oe ii1,?• 1... .), N
I ) 35444/
/ V --J 411,-A,„
\ / .-q---__ .____
Plumbini,
�( /- �, n+ Heating
R, / ���/..1/ Q ' • D
;/://7 v, Sewage I
%,1///:"_. L_ail Plans Re
•3la �l ..L/' Plans CII
'/VcrqV' u N10E I! Plans Re
-- -- Plans Pic
Plans Mf
/7/(-//'/
SOUTH .....
I hereby ' rtify information submi d is /• rect and there are no other structures I
a shown., r,
- . // .....t./..,
v.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONS
THIS IS NOTA PERMIT. PERMITS ARE NON-REFUNDABLE AND NON-TRANSFERABLE
DO NOT WRITE BELOW THIS LINE d
/ '.1