2005, 01-04 Permit App 05000020 MHProject Number: 05000020 Inv:
Site Information:
Plat Key: 000500 Name: CORBIN ADD TO GREENACRES District: East
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information: . . . . . . . . . . . . . . . .
Permit Use: DOUBLE WIDE MANUFACTURE HOME Contact: SATY, DOUGLAS & SHANNON
REPLACEMENT Address: 17906 E COWLEY AVE
C - S - Z: SPOKANE, WA 99016
Setbacks: Front 35 Left: 15 Right: 5+ Rear: 20+ Phone: (509) 891-2581
Group Name:
Project Name:
Parcel Number: 55184.1514 Block:
SiteAddress: 17906 E COWLEY AVE
Location:: GRE
Zoning: UR-3.5 Urban Residential 3.5
Water District
Lot:
Owner: Name: SATY, DOUGLAS & SHANNON
Address: 17906 E COWLEY AVE
SPOKANE, WA 99016
Hold: 0
Area: .00 Acres Width: 78 Depth: 295 Right Of Way (ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review
Site Plan Review
Plan Review
Originally Released: 12/27/2004 By: KKENDAL
de:4S
OK PER MANU SPECS
Originally Released: 01/04/2005 By: ddompier
Septic System Review
Pernzits:
Date: 01/04/2005 Page 1 of 2
4
Operator: DMD
Printed By: DMD
Print Date: 01/04/2005
01/07/2005 09:34 5093241567
JFIN 04 2005 10:02 FR
SRHD EHS
PAGE 01/01
TO 3241567 P.01/02
Project Number. 05000020 Inv: 1
]Penalties will be assessed for commenci
Application
THIS IS NOT A PET
work without a permit
Date: 01/04/2005
Page 1 of 2
Prbje 1 hi fcr tnation:
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Permit Use: DOUBLE WIDE MANUFACTURE HOME Contact~ SATY, DOUGLAS & SHANNON
REPLACEMENT • ' Address: 17906 E COWLEY AVE
C S - Z: SPOKANE, WA 99016
etbaaks:. Frdnt' 35 • Len: 15 Right: 5+ Rear: 204... Phone: (509) 891-2581
. Group ame;
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Project ame:
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Piat'Key: 000500 Name: CORBIN ADD TO GREENACRES District East
Parcel Number: 55184.1514 . Block:
SiteAddress: 17906 E COWLEY AVE
Location:: GRE
Zoning: UR-3.5
Wider District
An.sa: .00 Acres
Urban Residential 3.5
Width: 78
Nbr of Bldgs: 1 Nbr of Dwellings: 1
,Revive Informtz
Lot
Owner. Name: SATY, DOUGLAS t& SHANNON
Address: 17906 E COWLEY AVE
SPOKANE, WA 99016
Hold: O
Depth: 295 Right Of Way (ft).: 50
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Site Plan Review
Originally Release& 12/27/2004 By: KKENDAL
Plan :Review
OK PER MANU SPECS
Septic
•
Originally Released: 01/04/2005 By: Iddompier
tern Review
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Operator: DMD
Printed By: DMD
Print Date: 01/04/2005
JAN 07 2005 09:40
5093241567 PAGE.01
Project Number: 05000020 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Item Description
INSPECTION FEE
Notes:
Payment Summary::<,...
Permit Type
Manufactured Home
Manufactured Home
Date: 01/04/2005 Page 2 of 2
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
2 SECTIONS
Permit Total Fees:
Fee Amount
$100.00
$100.00
Fee Amount Invoice Amount Amount Paid Amount Owing
$100.00 $100.00 $0.00
$100.00
$100.00 $100.00 $0.00 $100.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: DMD Printed By: DMD Print Date: 01/04/2005
`I''ok nne
40,Valle
' BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
1707 E. Sprague Avenue, Suite 106
C : &ikane Valley, WA 99206
Ph • e: (50 ' ) 688-0 ' • 6; Fax: (509) 688-0037
REQUIRED SITE INFORMATION JS _�
Street Address: %''7
Cat3i
Assessor's Tax Parcel Number(s): (i7 n- /5/
D
[2 Change in Use ❑ Grading
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety
Legal Description:
PERMIT DESCRIPTION: N) L E - u),A 0PLE
Building Permit
Manufactured Home
❑ Other
j OWNER/APPLICANT INFORMATION
Owner:—h()_. (6-'S
Phone: i- j Fax: (_ ,`
Address: i'//7
City Stat J Zip Code
❑ Contractor:
Phone:
Address:
Fax:
City State Zip Code
WA State Contractor License #:
Applicant:
Phone:
Address:
iC
Fax:
City State Zip Code
❑ Architect:
Phone: Fax:
Address:
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
'(-1,/-x /
DIMENSIONS: -
CIZ-3a X
# OF STORIE.
i/�;
MAIN FLOOR TO SQ. FTG:
njx /6-c,(7,
2"" FLOOR SQ. FTG:
Al/1/4-
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANC��Y�GROUP:
_���
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS: .-D
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT: cc_ c
/ S
30% SLOPES ON PROPERTY:
SEWER OR ONN-SITE SEPTIC)
SYSTEM?
MANUFACTURED HOME
Width: e ength: ( Year: Pit Set:
Manufacturer:
• RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: _ Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Inspector:
Address:
Phone:
Fax:
City
Phone:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING
Firm Name:
CONCRETE ❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
❑ WELDING
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
111 Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
Print Map
Page 1 of 1
Information shown in the PRISM application is compiled from various sources, subject to ongoing changes and is not warm
accuracy. PRISM should serve as a starting point for your investigation or inquiry. Legal documents should be obtained fron
appropriate agency before taking any action. Please contact the appropriate county division or department for additional info
http://dorado/mox42/index.cfm?action=mox42 viewjrismprintablemap 12/27/2004
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