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1995, 05-02 Permit App: 95002870 MH PROJECT NUMBER= 95002870 APPLJCATICN DATE= 05/02/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 19011 E 4TH AVE PARCEL#= 55202 . 0110 ADDRESS= GREENACRES WA 99016 PERMIT USE= NEW DOUBLE WIDE MANUFACTURED HOME PLAT#= 005412 PLAT NAME= SP-877-93S� BLOCK= LOT= ZONE= UR-3.5 DIST#= F AREA= 00000000 F/A= F WIDTH= 166 DEPTH= 200 R/W= 40 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = CONSOLIDATED IRRG #1 OWNER= KOYBLUS, MARGARET PHONE= 509 922 9083 STREET= 12918 E BROADWAY AVE ADDRESS= SPOKANE WA 99216 CONTACT NAME= LEROY WEST PHONE NUMBER= 509 922 9083 BUILDING SETBACKS: FRONT= 25+ LEFT= 25+ RIGHT= 130 REAR= 64 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING REVIEW COORDINATOR - J SHATTO p1 / /. .! Dl) •l ` ' - 1 COMMENTS: BUILDING SETBACK REVIEW REQUIRED (5( COMMENTS: ENGINEER APPROACH/ DRAINAGE/ FLOOD -7;tthi ai/A„ 7 e-0 COMMENTS: 2: HEALTHDgST NE /OR AD I IONA W STE WATER 0( EC COMMENTS: PLANNING UNPLATTED/SEGREGATED PROPERTY COMMENTS: ?L.A- 87 7 '7 %�L r � FIRE DISTR FIRE DISTRICT REVIEW COMMENTS: DLL t- r,..>' T1- 6151`11UWC.-". -"" [ 4F4r`t{a t_ X75 a7 PROJECT NUMBER= 95002870 APPLICATION 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 • u• T IMPACT FEE= CV - MH Y 315 .00 IMPACT FEE=CV-MH (SR) Y 158 .00 �1 PLNG-PERMIT REVIEW; 119 Y 2 . S • 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 80 CL___ * PLAT NOTE: TOPIC = CONDITIONS DEPT = BUILDING (p)-17.5-0 WATER DISTRICT APPROVAL REQUIRED 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 ************************************ �' C\ PROJECT NUMBER= 95002870 APPLICATION , DATE= 05/03/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 19011 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= 166 DEPTH= 200 R/W= 40 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = CONSOLIDATED IRRG #1 OWNER= KOYBLUS, MARGARET PHONE= 509 922 9083 STREET= 12918 E BROADWAY AVE ADDRESS= SPOKANE WA 99216 CONTACT NAME= LEROY WEST PHONE NUMBER= 509 922 9083 BUILDING SETBACKS: FRONT= 25+ LEFT= 25+ RIGHT= 130 REAR= 64 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT ( BUILDING REVIEW COORDINATOR — J SHATTO k' COMMENTS: BUILDING SETBACK REVIEW REQUIRED L COMMENTS: ENGINEER APPROACH/ DRAINAGE/ FLOOD APPROVAL: 95—FNA-327 — APPROVED SYL DATE: 05/02/95 HEALTHDIST NEW OR ADDITIONAL WASTE WATER C _n��\ j COMMENTS: ‘ �1 PLANNING UNPLATTED/SEGREGATED PROPERTY APPROVAL: S. DAVENPORT—SP 877-93 TR "B" DATE: 05/02/95 FIRE DISTR FIRE DISTRICT REVIEW (C � 11 11/4.,(a_f (, 0 COMMENTS: C7f_ u,t' Con1Ktei.w T(01.4 era.. Ct,& 'SCA.tOA"tiO }(L t. trt9 A- '3 e f-ii.1 , ! E? • PROJECT NUMBER= 95002870 APPLICATION DATE= 05/03/95 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 ************************************ APPLICATION INFORMATION What is the JOB SITE address? ASSESSORS tax parcel number? �f' D // "4-/-4 Legal description as it appears on the property deed 5C6C1 Z / OWNER sfrOCCUPANT Phone 12-74/264/( -7- 7zz- �o�3 Mailing address City,state Zip Who should we contact regarding this project? Phone /© 5 GUEST What worl'is being done under this permit? i) m 0 r c{ f-b �Tc LS y S l L e1 U rC/ c✓ c„__)/07. c D 1) N©u S' S l EACCC5 Lone Inspector dlstnct Pr ey site Right 0f way width N w y D Water a n Building Building height #of stories Contractor ................ ._...................................._..........................................::>:> Dimensions TOTAL SQUARE 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 Home Sign Width: Length: What is the square footage of How high is the sign? the sign face? Year: 4 Make: Installer Contractor .Z/91 ,Z-/ E!�_ 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 Pool (Circle one) Above-ground Under round 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. 162.5`1= '1."' I(02.5"± �o Tro,ct 'C' Tro,c t 'D' . . it N co IONSESS. 7a ROAD WIDTH. ..Roy O Z�1 I25'± H COMMENT z-..., .. - REVIEWEO B . LANK/NG. 130/ +� k '75' >4 . RA It-.1 J-0$1' z4 44 Fie.L.1 I)" i - 1°' septic. `9 TAS k. OS" 2,6X(04; ia sm. Y1ANcs�+e. ( u f'Actoaect '« 3 Beatz.ao , Z SA-4h ,; aX24 oo C-4:4.° )- T // Mc.t?_c •, ra.e..T' Ko Lu Viltio 40' - - -'c_- - - ' PLOT 1 Erner. Ve.h. Tux.n PLAN 1 Around Ease. PLAN . Lot- 13, Tro.cf'B', Block 21 Ty-Ea-l- R I Corbin Acid iA-ion To Greehacces I SP-517-93 111.11.111111, No4 -to SCAIe.