2012, 02-28 Permit App BLD-2012-0040 MHSilo°lane
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 8-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
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(Staff disc' only
PERMIT NUMBER:
PERMIT FEE:
MANUFACTURED HOME PERMIT APPLICATION
L:i OTHER
SITE ADDRESS: 19329 E. Dove Circle
ASSESSORS PARCEL NO.: 55173.230i
LEGAL DESCRIPTION:
BUILDING OWNER NAME: Brenda Feldhusen
NAME: Brenda Feldhusen
ADDRESS: 3809 S. Virginia Lane
CITY: Spokane Valley
STATE: WA
p: 99203
PHONE: 509.998.4•
935
FAX:
CELL:
CONTACT NAME:
PHONE: 509.998.4935
FAX: CELL:
CONTRACTOR NAME: N/A
MAILING ADDRESS:
CITY: Spokane Valley
STATE: WA
ZX :99206
PHONE: 509.998.4935
FAX: CELL:
CONTRACTOR LICENSE NO.:
EXPIRES CITY BUSINE.t-35 LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Setting a now 2010 Single Wide Manufactured Home on the existing property, and hooking it up to the sewer.
MANUFACTURED HOME WIDTH: 13.6 ft
MANUFACTURED HOME LENGTH: 60 ft
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FEB 2 7 2012
`Prof ect
YEAR OF MANUFACTURED HOME: 2010
PIT SET: SEPTIC/SEWER: Sewe Name—_1'✓_ 1: �� _
MANUFACTURER: Clavton Homes l Suumittdl
PREVIOUS ADDRESS: The Home Boys Inc.
PROPOSED USE: Residential Home
DI,*cLAIMER
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 ' not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be re fired to be , bmitted and subse•uently approved before this application can be processed.
Signature Date: a 7 /.Z.�..�..,,�.
Method of payment: ■ Cash ' ■ Check ❑ Visa 0 Mastercard
Bankcard ;f:
Authorized Signature:
EXP:
Effective October 28, 2007 Page 1 of 1
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Manufactured Home Permit App 10.28.07.doc
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PLANNING DEPT. APPROVED
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