1996, 03-27 Permit App 96001813 MHPROJECT NUMBER= 96001813 APPLICATION DATE= 03/27/96 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 1212 N FLORA RD PARCEL#= 55182.0911
ADDRESS= GREENACRES WA 99016
PERMIT USE= REPLACE SINGLE WIDE MOBILE HOME / NEW /
PLAT#= 000130 PLAT NAME= BACON'S ADD TO GREENACRES
BLOCK= LOT= ZONE= UR 3.5 DIST#= H
AREA= 00000005 F/A= A WIDTH= 325 DEPTH= 584 R/W= 60
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= GELHAUSEN, ANDY
STREET= 2120 N COLEMAN RD
ADDRESS= SPOKANE WA 99212
PHONE= 509 928 3854
CONTACT NAME= ANDY GELHAUSEN PHONE NUMBER= 509 928 3854
BUILDING SETBACKS: FRONT= 40 LEFT= 45 RIGHT= 200 REAR= 200
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING SETBACK REVIEW REQUIRED
APPROVAL: J LARSON DATE: 03/27/96
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER PHONE=
YR/MAKE= 1996 FLEETWOOD MODEL=
SERIAL#= WIDTH= 14 LENGTH= 70 HEIGHT= 10
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
INSPECTION FEE 1 50.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 11.00
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 65.50 .00 65.50
65.50
PROCESSED BY: JOHN LARSON
PRINTED BY: JOHN LARSON
.00 65.50
******************************** THANK YOU ************************************
APPLICATION INFORMATION
'What is the JOB SITE address?rek), ASSESSOR'S tax parcel number?1, to . kvc, c SS1 ,09
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Legal description as it appears on the property deed
OWN R or OCCUPANT Phone
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Mailing addres City, state
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Zip
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Who should we contact r arding this project'? Phone
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What work being done under this permit?
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Lone
Inspector district
- ropert size
Right of way width
Water district
Building
Building height
# of stories
Contractor
'Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
-2nd floor area
-Finished basement area
ArchitecUEngineer
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
!Manufactured Home
'Sign
Width: 1/ /
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Length: i% /
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What is the square footage of
the sign face?
How high is the sign?
Year:0
Make: e:
Installer
Contractor
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Wa S ate Contractor license # / / / ! / ((r• /y c. /6 ') A/
Wa State Contractor license #
Mailing address
44
Mailing address
Relocation
Fire Safety
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
'Fuel
Storage Tanks 'Swimming
Pool
!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
E 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.
Site Plan
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INCLU THE FOLLOWING: <�
❑ All roadways, driveways & easments
❑ Distances from center of roads, right of ways,
private roads & property lines
O All existing & proposed buildings
❑ Underground utilities
❑ North arrow
❑ Septic tanks & wells