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2013, 02-04 Permit App: FAS-2013-0001 MH . Community Development Department (Staff Use Only) City or Permit Center 'Spokane 11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER: Spokane Valley, WA 99206 Valle Tel: (509) 688-0036 PERMIT FEE: Fax: (509) 688-0037 Y oermitcenter©sookanevalley.orq Project # , . 3—O/ MANUFACTURED HOME PERMIT APPLI¢ WF 0 OTHER SITE ADDRESS: -1ORa t (pAVE, kavt,C Vt / . 1) �� = i if2013 ASSESSORS PARCEL NO.: ,35 2L//, 2 90c/ LEGAL DESCRIPTION 4.T, iH,0 Ai E- 3 BUILDING OWNER NAME: Rif Jot DuwtA j Huyo i► Vf, His "-di, • NAME: obi n `t, Davy t,o Iuc Li e J »�_ -.i �/ ----moi ADDRESS: RO i/2 (✓. �( ' /h CITY: S jP O I`- 6. t.L V a,t(6 STATE: . ZIP: '/ 2 PHONE: 1 0 I -0 ( ) 7} FAX: CELL: � Imo/ CONTACT NAME: �(J(i ((S5a d Suk1a k ceuzvt j Tine PHONE: 509- 34,3 431-3 FAX:/ �J CELL: CONTRACTOR NAME: • MAILING ADDRESS: CITY: STATE: ZIP: PHONE: FAX: CELL: CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: 'To s-t_e, i F M 1 hao Iwvt o iy e co -ID 1,- ,a,‘ yc Y MANUFACTURED HOME WIDTH: 44 MANUFACTURED HOME LENGTH: 27 YEAR OF MANUFACTURED HOME: ()0 3 PIT SET: SEPTIC/SEWER: MANUFACTURER: Gol Gj e PREVIOUS ADDRESS: PROPOSED USE: • DISCLAIMER The permitted verifies,acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The City of Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional information may be required to be submitted and subsequently approved before this application can be processed. Signature At. ' �,Q,('G Dater ' /3 (_ I Updated 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Manufactured_Home_Permit_1-11-11.doc