2003, 10-15 Permit App BLD-03-02790 MHSpokane
m Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
MANUFACTURED HOME
Job Address: 18103 E COWLEY AVE
GREENACRES WA 99016-9390
Description: NEW DOUBLE WIDE MANUFACTURED HOME
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
PETTIBONE, KRISTINE A
PETTIBONE, KRISTINE A
18103 E COWLEY AVE
GREENACRES, WA 99016-9390
GARY'S BACKHOE SERVICE
17517 S MALLOY PRAIRIE RD
CHENEY WA 99004
Lot: Blk:
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Application #: BLD-03-02790
Applied:
Issued:
Expires:
Parcel No: 55184.1419
Phone: (509) 922-0831
Phone:
Lic No:
(509) 999-2819
GARYSBS055KJ
Zoning:
10/15/2003
04/12/2004
General Information:
SECTIONS
YEAR BUILT
DIMENSIONS
# OF STORIES
# OF BEDROOMS
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
MANUFACTURER
2w
2003
26' 8" X 52
1
3
26
100+
36
12
MARLETTE
Fees:
PER SECTION FEE
Total Calculated:
Deposits/Receipts:
Total Due:
100.00
100.00
0.00
100.00
CITY OF SPOKANE VALLEY
APPROVED FOR SUBMITTAL
Initials / Date
Building
Planning
Public Works
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THIS IS NOT A RECEIPT
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STREET ADDRESS:
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
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ASSESSOR'S TAX PARCEL NUMBER(S): c` 5 I K iiq I `.{
LEGAL DISCRIPTION: \1V COO iT 0 E'" Lot i a , \ \A)\V`\ F\c%S \R(Y m (1-3(1/4:(i; tck( v6
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PERMIT DESCRIPTION:
UILDING PERMIT' El CHANGE IN USE 0 GRADING MANUFACTURED HOME
® LOCATION ® SIGN Q TENANT MOTHER
OWNER / APPLICANT INFORMATION
®OWNER: Kv to Rs \"'' \
PHONE: CribttNI0 D3I
ADDRESS: Ikon' ECCt)-\FA
CONTRACTOR: sQ y
PHONE:
FAX:
rlb
,
(OcCEA Cv 5% ) \ARTOW
CITY,STATE, ZIP
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1 HO—U\(l FAX: 3S")S tG%
ADDRESS: 11 1 3 - \CAS Pr GQ V PA e-Sp
CITY,. STATE, ZIP CITY, STATE, ZIP
cA
WA ST CONTRACTOR LICENSE XT- "tFr CONTACT:
APPLICANT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
3-
ARCHITECT:
PHONE:
ADDRESS.
FAX:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:
BUILDING HEIGHT TO PEAK: yc:^
BUILDING DIMENSIONS: aJ
NUMBER OF STORIES:
NUMBER of BEDROOMS: -3
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
STRUCTURES ON PROPERTY: 2z
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE:
CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT:
2No FLOOR SQ FT:
I3h 7
UNFIN BASEMENT:
FINISHED BASEMENT:
GARAGE:
COVERED DECK:
DECK:
MANUFACTURED HOME SIGN
„
WIDTH: a��LENGTH; ��(.
YEAR: aUO� PIT SET: r'� 1 `t
MANUFACTURER: \ ( F-
SQ FT OF SIGN: HEIGHT OF SIGN:
# OF SIGNS: AREA OF EXIST SIGN:
TYPE OF SIGN:
RELOCATION FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
® BOLTING ®CONCRETE ® REINFORCEMENT
FIRM NAME:
INSPECTOR(S):
PHONE:
® WELDING
FAX:
BUILDING STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: ® YES ® NO IF YES: ® COUNTY ® CITY
IS PUBLIC WATER AVAILABLE: 0 YES ® NO IF YES, WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES ® NO
IS THE PROPERTY LOCATED WITHIN ASA: ElYES ® NO
PSSA: 0 YES 0 NO
I
DATE:
I
STAFF:
I
METHOD OF PAYMENT;
0
CASH CHECK
VISA
SANKCARD 1t,' EXPIRES; VIN #
AUTHORIZED SIGNATURE.
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
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0401-t (1.36C4)o_A noou)
APPROVED
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