2000, 05-18 Permit App: 00003968 MHProject Number: 00003968 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/18/2000 Page 1 of 2
Project Information:
Permit Use: TRIPLE WIDE MOBILE HOME
Setbacks: Front 35 Left: 19 Right: 5 Rear: 42
Site Information:
Plat Key: MH003 Name: LA CONNIE PARK
Parcel Number: 45202.1604 Block: 1
Contact: MCCORMICK, SHELLEY
Address: 12309 E PORTLAND
C - S - Z: SPOKANE, WA 99216
Phone: (509) 465-2519
Group Name:
Project Name:
Lot: 4
District: F
SiteAddress: 9511 E 7TH AVE Owner: Name: MCCORMICK, SHELLEY
SPOKANE, WA USA 00000 Address: 12309 E PORTLAND
Location:: SPO SPOKANE, WA 99216
Zoning: UR -7
Water District:
Urban Residential -7
Hold: ❑
Area: 8,190 Sq Ft Width: 65 Depth: 126 Right Of Way (ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Department
BUILDING
Hold Reasons:
Permit Conditions:
BUILDING
Hold Reasons:
Permit Conditions:
Permits: ra
Review
Site Plan Review
Plan Review
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
INSPECTION FEE
COUNTY SURCHARGE
By: 7.1.lA. 6./3 -�
By: GUA11'
Manufactured Home
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
3 SECTIONS
1 Y OR BLANK
Permit Total Fees:
Fee Amount
$150.00
$33.00
$183.00
Project Number: 00003968 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
Operator: CKF
Permit Type
Manufactured Home
Date: 05/18/2000 Page 2 of 2
Printed By: CKF
Print Date: 05/18/2000
Fee Amount Invoice Amount Amount Paid Amount Owing
$0.00 $18100
$183.00 $183.00
$183.00
$183.00
$0.00 $183.00
Notes:_<.
SPolcpNECouNrr
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description: N ft l.J /1% /9 Al UAW 2-0,,e gime D rl% Z o �`
TYPE OF APPLICATION
O Building Permit
❑ Change in Use
0 Grading
0-14auufactured Home Permit
O Relocation
0 Sign
0 Tenant (New/Change)
0 Other
SPECIFIC SITE INFORMATION
Street Address: % S// , - 7 t-1° 5 /ed,/r-or ,rj r/ 9 9.2
3 6
Phone
Far
Assessor's Tax Parcel Number(s): / 7 7
i--15 232— 1 co.014
Dimensions
Legal Description:
Lar'/ %3L act' / LnconloI'
file oil. tip/i7L
"/>'6'/e
sonrr ctor • '
R. (,t/ /U /E c S el
-
lil 4'
tecta.
;gi
Mailing address
Heat source (electric, gas, etc)
fl5e artment lse
W Or
ys: tsrrl /Pu .`
City, State Zip
s n, /f Ad P:_ L,)/9
t5r Dri
City, State Zip
Aad width
x 6C)
?Setbacks
FS40
:Leh-
..
B
CLA4IOC'
Fire DurtkIf� X
, .-
Zoning ..
OWNER/APPLICANT INFORMATION
0 Indicate who should be c nmered regarding this project
irOwner: Phone, ybi —ar/9
S IAF L L F_ /`/1/ r siertr�a
0 Applicant:
Phone
Far
/
Mailing Address:
F / 3 0 9 Po C IL- N N b
Mailing Address:
Dimensions
City, State, Zip
S#a,L'/tth' c,)/9 94, /4
City, State, Zip
Finished basement sq. ft.
sonrr ctor • '
R. (,t/ /U /E c S el
Phone
Fax Fax
O Architect/Engineer
Phone
Fax
Mailing address
Heat source (electric, gas, etc)
Mailing address
City, State Zip
s n, /f Ad P:_ L,)/9
99?a6
City, State Zip
WA Slate Contactor license #
Contact name:
PROJECT INFORMATION
Building Information
Building height to peak
r of stories
Mak floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2^d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
Heat source (electric, gas, etc)
err
lYlal ufa4 pred-f� > Ie «.
i
l tt.
Previous address
s
— —21 �r AnN.d,
Widrh:ILength:40
40
Fireworks display
WWhatsthe square footage
ace?
6e sign
How high is rhe sign?
Year:
a a'a a.
Make: Ho /'n a I
/Ju,'CPE.P s N W
M of signs
Area of existing signs
4?'� Y 3 Ae;S•b � aI
Ref(icatiai�
i
tte4 pi 4 J ;
v}x.44c... et YA�...1u. y•
Previous address
Fire Sprinkler
Tent
_
Paint booth Fire Alarm
Fireworks display
_ _
Phone
Proposed use
Value
Sp ff2
• 94t?o
"gym .L
tte4 pi 4 J ;
v}x.44c... et YA�...1u. y•
;Nofbaesidtntiaf
anergy Bode Compfianre?
Finn Name
Phone
Are or will there be wells located on the property?
Ifyes, idenrifi on the site plan 0 Yes Er
Plans Examiner
Phone
Inspectors
Are critical or hazardous materials used or stored on site
0 Yes No
Address
Inspector
Phone
0 Concrete 0 Welding
0 Bolting
❑ Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the properly? 0 Yes GYflo
If yes, identify on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shorelinyy?
Ifyes, idents on site plan 0 Yes E No
What is the current use of this property?
/
Is your property in a designated wildlife habitat area? ,t
0 Don't know 0 Yes o
Will the site be served by a septic system? 0 Yes [31--‘
Is any part of the property within a 100 yr flood plain?
If yes, identi on siteplarj
0 Maybe ®'Dont know 0 Yes 0 No
Are or will there be wells located on the property?
Ifyes, idenrifi on the site plan 0 Yes Er
Are there any wetlands, streams or ponds within 200 feet of the
prop,? //
Ifyes, idenri on site plan 0 Yes f17�[s10
Is there evidence of fill or excavation on the property? /
❑ Yes No
Are there slopes greater than 30% on the property? (30 rise in 100 ft)
(/%) 0 Yes No
Are critical or hazardous materials used or stored on site
0 Yes No
DEPARTMENT USE ONLY
kiss the propprij%aryadestg tea See'
al CoVio Area?"aya..3PS+I7plt�+(tt'.Sewer
alyptlable to•thesi4e? C" Yses 0No
Is the.propein; tde tEfe..SQ?
=D €s p X10. y°
❑.. t4
Is publte warer'aviilable to tha°si e? 0 Yee O' No
'I4t a"propertyiinsidee PSSA?
"'
i4 p0'7CS'-' (x N'o gin^ iti
Ls th6p-op€rty?16catedwithin'{6,:fee* of x Natural Resource
0 Yes 'q.No
Date Received
Staff Representative:
This site ^'an is being submitted for the purpose of
obtaining a building permit and is a true and correct
representation of the proposal. All known property
lines/dimensions. curb lines, structures and easements`
have been identified. Also indicated are wetlands,
bodies of water, steep slopes or other critical areas.
Sighed:�
Date:
ADDRESS C15l t E
ZONE U .7
ROAD WIDTI1.0
FRONT 5 FLANKING
COMMENTS
REVIEWED BY
..- 8 -i
p..c
t
0
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