2012, 11-01 Permit: FAS-2012-0009 Inspect h C 1)4:(4C,C
pokane
MANUFACTURED HOME INSPECTION RECORD CARD
PERMIT #: "p/a - 000
Valle OWNER: /fA7- c, (,J/iS ,/✓
y ADDRESS: </071/'
/7 � �— y
MANUFACTURER ��1�C)rsT MANUF DATE: /7 7
MODEL: SERIAL NUMBER:
"HUD" LABEL/STATE LABEL NUMBER: DATA PLATE:
DEALER: DEALER#:
ELECTRICAL-L& I FINAL APPROVAL:
INSTALLER: ing SJnp J1'/o� WAYNES#: 6 003- 3 z/5.--69
INSTALLER: WAYNES#:
INSTALLER: WAYNES#:
INSTALLER: WAYNES#:
INSTALLATION
INSTALLATION #: ANCHOR#:
INSTRUCTIONS US. MANUFACTURER: STATE:
NFPA 225
FOUNDATION: FOUNDATION TO LOCAL BLDG CODE:
SUPPORT: SUPPORT LOCATIONS PER MANUFACTURER OR ENGINEERED DESIGN:
ELEVATION: ELEVATION OF LOWEST FLOOR(IF IN A FLOOD HAZARD AREA):
SUPPORT FOOTINI TYPE:
SIZE: 5? X 112
PIERS: MATERIAL be 5
SPACING: e
SHIMS: Yes
LOT/SOIL CONDITIONS:
ANCHORS: SPACING: ryj ;,t; m4tv' (
EQUIPMENT USED: Mi'r>U✓ ,i Acid elow,-, S4^AI?c
EQUIPMENT APPROVED: Te S
FRAME REMOVED: PERMITED BY MANUFACTURER:
(PRIOR TO 11/89)
�..
FOUNDATION TO LOCAL BLDG CODE: rX i`si>�' 5dy t--1
13 ea
SUPPORT LOCATIONS PER MANUFACATURER OR E1(JGINEERD DESIGN:
ELEVATION OF LOWEST FLOOR(IF IN A FLOOD HAZARD AREA):
SKIRTING: TYPE: , ety l
ATTACHMENT TO HOME: '
POLY ON GRADE: Ye,
ACCESS PANEL: Ye's
COMMENTS A 'o,4y5 / 4r21/K," /3 2 yOr.;
( , r7-/f /,501 s 4i/
I h S/` ff4f UP✓ 5 tri- AndA2 -
*FINAL APPROVAL MEETS THE REQUIREMENTS FOR TITLE ELIMINATION EXCEPT FOR PARK PLACEMENT*
INSPECTOR: 1604, DATE/TIME: //- / - Je9 - /pi
ORIGINAL COPY:CITY OF SPOKANE VALLEY ADDRESS FILE COPY FOR OWNER