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1995, 05-04 Permit App: 95002867 MH . PROJECT NUMBER= 95002867 APPLICATION DATE= 05/04/95 PAGE= 01 1 1 \ f ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 19009 E 4TH AVE PARCEL#= 55202 .0110 ADDRESS= GREENACRES WA 99016 PERMIT USE= NEW DOUBLE WIDE MANUFACTURED HOME PLAT#= 005412 PLAT NAME= SP-877-93 BLOCK= LOT= ZONE= UR-3.5 DIST#= F AREA= 00000000 F/A= F WIDTH= 148 DEPTH= 199 R/W= 40 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = CONSOLIDATED IRRG #1 OWNER= WEST, LEROY & PATRICE PHONE= 509 922 9083 STREET= PO BOX 609 ADDRESS= GREENACRES WA 99016 CONTACT NAME= LEROY WEST PHONE NUMBER= 509 922 9083 BUILDING SETBACKS: FRONT= 60 LEFT= 20 RIGHT= 113 REAR= 60 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT • BUILDING REVIEW COORDINATOR — J SHATTO COMMENTS: BUILDING SETBACK REVIEW REQUIRED r a. � ll COMMENTS: ENGINEER APPROACH/ DRAINAGE/ FLOOD APPROVAL: 95—FNA-326 — APPROVED SYL DATE: 05/02/95 HEALTHDIST NEW OR ADDITIONAL WASTE WATER CI\ , COMMENTS: PLANNING UNPLATTED/SEGREGATED PROPERTY APPROVAL: S. DAVENPORT — SP 877-95 DATE: 05/02/95 ) FIRE DISTR FIRE DISTRICT REVIEW i t COMMENTS: \1 �7:2,:AY�c '_'' C tt" 4, PROJECT NUMBER= 95002867 APPLICATION DATE= 05/04/95 PAGE= 02 ****************************** MOBILE HOME PERMIT ***************************** CONTRACTOR= OWNER PHONE= YR/MAKE= 1995 MODULINE MODEL= SERIAL#= WIDTH= 28 LENGTH= 66 HEIGHT= 00 ITEM DESCRIPTION QUANTITY FEE AMOUNT IMPACT FEE= CV 750 750. 00 IMPACT FEE= PARKS - MH Y 400.00 PLNG-PERMIT REVIEW; 119 Y 22 . 00 INSPECTION FEE 2 100. 00 STATE SURCHARGE Y 4 .50 COUNTY SURCHARGE Y 18. 00 ***************************** MISC FEES DUE ****************************** CONTRACTOR= OWNER PHONE= ITEM DESCRIPTION QUANTITY FEE AMOUNT APPROACH INSPECTION 1 20.00 APPROACH PERMIT 1 10.00 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING MANUFACTURED HM 1294 .50 .00 1294 .50 MISC FEES DUE 30. 00 .00 30. 00 1324 .50 . 00 1324 .50 PROCESSED BY: JULIE SHATTO PRINTED BY: JULIE SHATTO ******************************** THANK YOU ************************************ PROJECT NUMBER= 95002867 APPL;CAT 1JN DATE= 05/02/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 19009 E 4TH AVE PARCEL#= 55202 .0110 ADDRESS= GREENACRES WA 99016 PERMIT USE= NEW DOUBLE WIDE MANUFACTURED HOME PLAT#= 005412 PLAT NAME= SP-877-93 BLOCK= LOT= A ZONE= UR-3.5 DIST#= F AREA= 00000000 F/A= F WIDTH= 148 DEPTH= 199 R/W= 40 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = CONSOLIDATED IRRG #1 OWNER= WEST, LEROY & PATRICE PHONE= 509 922 9083 STREET= PO BOX 609 ADDRESS= GREENACRES WA 99016 CONTACT NAME= LEROY WEST PHONE NUMBER= 509 922 9083 BUILDING SETBACKS: FRONT= 60 LEFT= 20 RIGHT= 113 REAR= 60 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING REVIEW COORDINATOR - J SHATTO COMMENTS: BUILDING SETBACK REVIEW REQUIRED OIL S. � � K'""" 5_A-- COMMENTS: ENGINEER APPROACH/ DRAINAGE/ FLOOD ` , it 5 prAffir3.Z.te Q/4.J4,/Cf COMMENTS: / HEALTHDIST NEW OR ADDITIONAL WASTE WATER 6P: 5-5- COMMENTS: PLANNING UNPLATTED/SEGREGATED PROPERTY COMMENTS: � �-t�Z t 7?ie 87 77 ' l5 5/Os FIRE DISTR FIRE DISTRICT REVIEW COMMENTS: .. ,� PROJECT NUMBER= 95002867 ARPL'ICATION DATE= 05/02/95 PAGE= 02 ****************************** MOBILE HOME PERMIT ***************************** CONTRACTOR= OWNER PHONE= YR/MAKE= 1995 MODULINE MODEL= SERIAL#= WIDTH= 28 LENGTH= 66 HEIGHT= 00 ITEM DESCRIPTION QUANTITY FEE AMOUNT IMPACT FEE= CV - MH Y 15 . 00 IMPACT FEE=CV-MH (SR) Y 158 . 0 2 PLNG-PERMIT REVIEW; 119 Y 0 INSPECTION FEE 2 100.00 STATE SURCHARGE Y 4 .50 COUNTY SURCHARGE Y 18 . 00 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING MANUFACTURED HM 617 .50 . 00 617 .50 617 .50 .00 617 .50 3o-a0 cc/k_ ********************************************************* ********** * PLAT NOTE: TOPIC = CONDITIONS DEPT = BUILD G 71J 0 • ******************************************************** ************ ******** WATER DISTRICT APPROVAL REQUIRED fl1L k- r"1/4.'Sc .1 0-a(v'C% FIRE DISTRICT CONDITIONS MUST BE APPROVED BY FIRE DIST. PRIVATE ROAD/DRIVEWAY STANDARDS MAY APPLY PROCESSED BY: JULIE SHATTO PRINTED BY: JULIE SHATTO ******************************** THANK YOU ************************************ APPLICATION INFORMATION What is the JOB SITE address? ASSESSOR'S tax parcel number? o © 7 4 40 eei3O 99a7� Legal description as it appears on the property deed A/(A) 01—/(- s � zo T®e-c/,v zY N '5 L-e-/ ' i S, 7 /( e7/ f3coc.4 z/ Go7 OWNER sr OCCUPANT Phone Mailing address City,state Zip jam. 0 ' 5 6 x C 0 96 r E�,oc4/Fs- Ivo l9 o/c —O( Who should twee contact regarding this project? Phone What wor(is being done under this permit? /) a b e, vo C j .0',E".0 c' E R V iJ©2 i , S c P-T/C Sy:S1-E'4-7 � DiC.i L?t=��� / OEC"K3 .o"'vo -;'c/VC / Lon# Inspector distnc; #'roperty size Fight of way;width m N m /`'� Buildin Building height #of stories SQUARE Dimensions TOTAL FOOTAGE WA State Contractor license# Main floor area . Unfinished basement area 'Mailing address 2nd floor area Finished basement area Architect/Engineer Garage area Size of decks,etc. What is the heat source? ° What is the cost of your project? Manufactured Hemi Sign Width: Length: What is the square footage of How high is the sign? the sign face o... • jait es7z4i Year: / � Make: �S izJ mo06,6/A/E • Installer Contractor /4141 P /‘,</7EX. Wa State Contractor license# Wa State Contractor license# Mailing address Mailing address Relocation Fire Safety Previous address Fire Sprinkler _ Tent _ Paint booth_ Fire Alarm _ Fireworks display _ VALUE Contractor Contractor WA State Contractor license# WA State Contractor license# Mailing address Mailing address Fuel Storage Tanks Swimming Poot (Circle one) Above-ground Underground Size/gallons Private Contents of tank(s) Size/gallons Public/semi-private Contractor Contractor Wa State Contractor license# WA State Contractor license# Mailing address Mailing address COMPLETE ALL APPLICABLE INFORMATION Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in,its programs or activities. N + H--- it) I -,104/ ‘.9.• 104/ aR r"'It.1c6:471,74. �� 7s % Q 9 _ QiirA, Nr. .r 241 cyje. A-4441 1 rFlo y SG II • 15' V ZZ xzd �t,, 1A' � � Z.<6 x G 4T, .< 71' YY\Ar.1 U.FAC p,t 4~pw, . 3 Zediacc 2. 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