1996, 07-23 Permit App: 96005806 MH PROJECT NUMBER= 96005806 APPLICATION DATE= 07/23/96 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 223 N SHAMROCK ST PARCEL#`= 45134.2204
ADDRESS= VERADALE WA 99037
PERMIT USE= NEW DOUBLE WIDE MOBILE HOME
PLATO= 005236 PLAT NAME= ARMSTRONG ESTATES
BLOCK= 1 LOT= 4 ZONE= UR-3.5 DIST#`= F
AREA= 00010163 F/A= F WIDTH= 85 DEPTH= 120 R/W= 50
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = VERA
OWNER= STREBECK, DON K. PHONE= 509 928 7213
STREET= 223 N SHAMROCK ST
ADDRESS= VERADALE WA 99037
CONTACT NAME= DON STREBECK PHONE NUMBER= 509 928 7213
BUILDING SETBACKS: FRONT= iC" LEFT= 41T. RIGHT= U04REAR=
It) 5 o+'
****************************** REVIEW INFORMATION **********w******************
DEPARTMENT REVIEW REQUIREMENT
BUILDING SETBACK REVIEW REQUIRED ati. iA
COMMENTS: I -2-3 •C
ENGINEER APPROACH/ DRAINAGE/ FLOOD 7f -
A A. % /
COMMENTS:
HEALTHDIST NEW OR ADDITIONAL WASTE WATER t) /ctLL_ T1
2/*
COMMENTS:
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER PHONE=
YR/MAKE= 1996 PALM HARBOR MODEL=
SERIAL#`= WIDTH= 27 LENGTH= 64 HEIGHT= 10
ITEM DESCRIPTION QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 22.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
PROJECT NUMBER= 96005806 APPLICATION DATE= 07/23/96 PAGE= 02
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 126.50 .00 126.50
126.50 .00 126.50
/6
PROCESSED BY: CAROL FRAZIER J-510 Sr)
PRINTED BY: CAROL FRAZIER
******************************** THANK YOU ************************************
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APPLICATION INFORMATION
What is the JOB SITE address? ASSESSORS tax parcel number?
21- '3 I') , hiii.-/-kt ROLL i//e1 1),4Lg- ; w'- ggv37 5jsi.3/, 2-`-z-0,1
Legal description as it appears on the property deed
AR rr► s-74—X O A 6 E-S721 -re:5 -T y/ i3l. 'J,
OWNER or OCCUPANT Phone
,ti K - 54-,et 13 C--F-e--k._ 9-z- - 7z /3
Mailing address City,state Zip
z 2- 3 A) • Aivi-1 ,47s ilEx,,i Dg 46- , 'di. ,9037
Who should we contact regarding this project? Phone
2)D 11) K S1,26i e--4-- 2 — 77 /3
What work is being done under this permit?
/rip-ivaP.9-e ue P /Ve147
lone Inspector district: Property size Right of way width
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Water district:....
/ Building Building height #of stories..
B ' in '
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 ` Sigrn:` 1
Width: Length: What is the square footage of How high is the sign?J
2 7 / 4 / he sign face?
Year: ! Make:
gel0 P/iLmro /�L/i4/ 3O/Z-
Installer Contractor
Q0-4'L/ 1f /T�e
War(:
�1�zac�license 4+ L Wa State Contractor license#
Ma�na ade ) /0 r e /`` q c Mailing address
l4,4- y &A) .2-ir ti YA-1,10 F 3S 3 c
Relocation Fire Safet
Y
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
11u;70l 3toragTa k� SwimmingPool
(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.
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