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2002, 11-27 Permit App 02010655 Relocate MHProject Number: 02010655 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: RELOCATION OF SINGLE WIDE Contact: KORY YORK, MICHELLE MORROW MANUFACTURED HOME Setbacks: Front 5 Left: 5 Right: 5 Rear: 5 Site Information: ............................................................................. ............................................................................... Plat Key: 005186 Name: CENTRAL MHP Date: 11/27/2002 Page 1 of 2 Address: 421 S HOWE C - S - Z: SPOKANE, WA 99212 Phone: (509) 216-0850 Group Name: Project Name: District: Parcel Number: 35231.6001 Block: Lot: SiteAddress: 421 S HOWE RD SPOKANE, WA USA 00000 Location:: SPO Zoning: UR 7 Water District: Urban Residential-7 Owner: Name: KORY YORK, MICHELLE MORR Address: 421 S HOWE SPOKANE, WA 99212 Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: :. Review Plan Review Rel se iBy: QQ. v ..>- itr7 /�'i Special Reviews Permits: 4- Released By: 4194d ci Contractor: OWNER Item Description INSPECTION FEE COUNTY SURCHARGE Manufactured Home Firm: OWNER Phone: Units Unit Desc 1 SECTIONS 1 Y OR BLANK Fee Amount $50.00 $11.00 Permit Total Fees: $61.00 Operator: RMB Printed By: RMB Print Date: 11/27/2002 Project Number: 02010655 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit ............... .............. ............... .............. .................................. ................................ ................................. ................................... CONTOL AREA FOR DRAINAGE MORITORIUM SEE MAPS FOR SPECIFICS Payment Summary::;::;.; Permit Type Manufactured Home Date: 11/27/2002 Page 2 of 2 Fee Amount Invoice Amount Amount Paid Amount Owing $61.00 $61.00 $0.00 $61.00 $61.00 $61.00 $0.00 $61.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and fords 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: RMB Printed By: RMB Print Date: 11/27/2002 PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 \VEST BRO.ADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: C Assessor's Tax Parcel Numher(s): Legal Description: 99� / Project Description: 0 Building Pennit O Change in Use El Grading -0(Manufacrurecl Home Permit O Relocation O Sign El Tenant (New/Change) O Other Department Use Only �C'ater District/pi,n j'or Se ,er Dist tici/Pun-eror Road with Setbacks Mont Rear: cfr. R ght: School Distract Fire District: "Zoning OWNER/APPLICANT INFORMATION Q Indiute uho.rhmdd Ge ionluded m(a;ali t? IN, Ironed ❑ On nee: rrIt „g KQ r,..4 rho c . (4, - p SO El Applicant Phone: Fax: r rt,)((Phone:( q) y a rL._ Fax Mailing Address: Lai s . Ott L©-\- th. 1 Mailing Address: City, State, Zip Sy�t) o 1 Ln rl c? 0?/ (s006 -ogso City, State, Zip Contractor Phone Fax ❑ Architect/Engineer Phone. Fax Mailing address Mailing address City, State Zip City, State Zip WA State Contractor license # Contact name: PROTECT INFORMATION Building Information Building height to peak # of stories Main floor sq. ft. Unfinished basement sq. ft. Dimensions Total habitable space 2"d floor sq. ft. Finished basement sq. ft. Occupancy group Construction hype Garage sq. ft. Deck sq. ft. Cost of project Heat source (electric, gas, etc.) Manufactured Home Sign \X'idth: l t Length: Co i What is the square footage of the sign face? How high is the sign? Year: 19 c 6 Make: \)OX\ AkC2-- _# of signs Area of existing signs Relocation Fire Safety Previous address Paint booth Fire Sprinkler 'Tent Fire Alarm Fireworks displav Proposed use Value Special Inspections Required? - Non -Residential Energy Code Compliance? Firm Name Phone Plans Examiner Phone Inspectors: Address Inspector Phone ❑ Concrete ❑ Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Arc there structures on the property? 0 Yes 0 No If yes, identify o✓1 site plan What is the current property size? (square feet or acres) Is any part of the property within 250 feet of a shoreline? If yes, identify on site plan ❑ Yes 0 No What is the current use of this property? Is your property in a designated wildlife habitat area? 0 Don't know 0 Ycs 0 No Will the site be served by a septic systetn? 0 Yes 0 No Is any part of the property within a 100 yr flood plain? I, f yes, identft on site plan 0 Maybe 0 Don't know 0 Ycs 0 No Are or will there be wells located on the property? I f yes, idenierp all the site plan 0 Yes 0 No Arc there any wetlands, streams or ponds within 200 feet of the property? "[yes, identify on site plan 0 Ycs 0 No Is there evidence of fill or excavation on the property? 0 Yes 0 No Arc there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( _./ %) 0 Ycs 0 No Are critical or hazardous materials used or stored on site? 0 Yes 0 No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? OYes ❑No Is public sewer available to the site? 0 Yes 0 No Is the property inside the ASA? 0 Ycs ❑ No OYes ONo Is public water available to the site? 0 Yes 0 No Is the property inside the PSSi\? 0 Ycs 0 No Is the property located within 1000 feet of a Natural Resource Area? 0 Yes 0 No Date Received: Staff Representative: METHOD OF PAYMENT VISA ❑ CASII ❑ CHECK p ❑ . ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD Ii\PIRIiS: B:ANKCARI NUMBER: AUTIIORIZED SIGNATURE: SUB '1'O'I'A1, TOTAL FEE MINIMUM PERMIT FEE IS $35.0O PLEASE LAKE CHECKS' PAYAI3LE TO SPOI:ANE COUNTY PERNIrr CENTER