2010, 03-02 Permit App 10000556 MH4„•0* Valley t
CITY OF SPOKANE VALLEY
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
oermitcenterOspokanevallev. orq
(Staff Use Only)
PERMIT NUMBER: `4J O S >
PERMIT FEE:
RECEIVED \
CSV PERMIT CENTER
R022010
Project 4--
MANUFACTURED HOME PERMIT APPLATIO
0 OTHER
SITE ADDRESS: I +7 9 j,j 1^
ASSESSORS PARCEL NO.:
i
LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: 06-4 , f ,4 '- ` `•ca
ADDRESS: / r.2.3 / �j exw c,ees
CITY + e (/ ft //`e.
STATE: .iJ Q -
el, Seca
CONTACT NAME: ,�
PHONE: -��ra�� ' (/02�$� FAX:
CONTRACTOR NAME: -6 • 2L
MAILING ADDRESS: C: , (cl i 0\ al 1 t J kJ A v 1 eA -
Crry: (C• Li, pia"]_
PHONE: .. 466469,i
c t�
zIP: 9w037
CELL:
CELL:
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--y
STATE: to 4 ZIP: 95 1
FAX: 62)5 416 Si 0 2 7 CELL: 419 i t Lj
CONTRACTOR LICENSE No.: De „Its, 1 CGe1 13,K EXPIRES: !/ f f / CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE Of WORK IN DETAIL AND INDICATE USE:
Fog Foe) 71 ,ra s F', T- :SA i N 1 u J rr1 A ,v rz if"
MANUFACTURED HOME WIDTH: i'
MANUFACTURED HOME LENGTH: 5a2
YEAR OF MANUFACTURED HOME: 14 if t.4�
PIT SET:
CC®TYl' icctalcn.
MANUFACTURER: V fk--NR.L E
PREVIOUS ADDRESS:
PROPOSED USE:
DISCLAIMER
The permitted verifl c, 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 cf 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 is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to he submitted and subsequently approved before this application can be processed.
Signature Date:
Method of payment: 0 Cash
Bankcard #:
Authori_ed Signature:
Ci Check
eck 0 Visa (*Mastercard
NO EXP: � - l A - VIN#:
This document originally contained
confidential credit card Information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to 505 DAN G52014-030.
Project Number: 10000556 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date: 3/3/2010 Page 1 of 2
Permit Use: 2010 MARLETTE 30 X 52 Contact: GILICA, VICTOR F & PATRICIA A
Address: 1823 S VERACREST
C - S - Z: VERADALE, WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 000-0000
Group Name:
Site Information: Project Name:
Plat Key: CONV Name: CONVERTED CNTY DATA
District: East
Parcel Number. 55074.0516 Block:
SiteAddress: 17915 E INDIANA AVE
Location:: CSV
Lot:
Owner: Name: GLLICA, VICTOR F & PATRICIA A
Address: 1823 S VERACREST
VERADALE, WA 99037
Zoning: R-3 SF Res District
Water District: 134 CONSOLIDATED ID #19
Hold: ❑
Area: 14,000 Sq Ft Width: 100 Depth: 150 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Landuse/Zoning/HE Conditions
Released By:
Sewer Review
Permits:
Originally Released: 3/2/2010 By: tschmidt
Released By:
Contractor: OWNER
Item Description
SETTING PERMIT
Manufactured Home
Firm: OWNER
Phone:
Units Unit Desc
2 # SECTIONS
(000) 000-0000
Fee Amount
$100.00
Permit Total Fees: $100.00
Operator: JD Printed By: JD
Print Date: 3/3/2010
Project Number: 10000556 Inv: 1
Date: 3/3/2010 Page 2 of 2
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes: _ _ :
Payment Summary: --
Permit Type
Manufactured Home
Fee Amount Invoice Amount
$100.00
$100.00
Amount Paid Amount Owing
$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: JD Printed By: JD
Print Date: 3/3/2010
Spokane
jUalley
For City Use Only
PLUS Project Number
Project Address
11703 E Sprague Ave Suite B-3 • Spokane Valley WA 99206
509.688.0036 ♦ Fax: 509.688.0037 • permitcenter@spokanevalley.org
As part of our on -going commitment to customer service during the review process of your project
application, we are providing you with a TARGET DATE for the initial technical application review. If for
any reason we cannot meet this date, we will contact you with a revised target date.
Your application review TARGET DATE is
The TARGET DATE is the date we estimate your project application will have had its initial technical
review. It is not the date for approval or permit issuance.
Tips for a Smoother Project Application Review
➢ Submit complete, accurate plans and documents.
Extra time may be required for re -submittals as project application reviewers work on multiple applications and it
may be several days before they can look at your new or revised information.
> Designate a specific contact person to communicate with the City.
While the person designated as the applicant's contact person with the City can be changed, one individual with the
expertise for dealing with reviewer comments would be the best choice for the entire review process.
> Call staff regarding the status of your project only after the target date shown at the top of the page.
Although you should be contacted on or by the target date, please feel free to contact us if you haven't heard from us
by your target date. Staff may contact you before the target date if the initial review is complete. By following this
procedure, you will save time and allow the reviewers to complete the work more expeditiously.
Steps in the Permit Process
1. Counter Complete. Your application has been accepted as counter complete. This means all of the required
documents, as indicated on your Pre -Application Checklist have been submitted or have been approved for deferred
submittal. This does not prevent technical staff from requesting additional information as a result of their technical review.
2. Quality Check. The next step in the process is a quality check to make sure that the application is reviewable and free
from substantive flaws that would prevent technical staff from completing the technical review once it is started. When
this step is complete, your application will be routed to the appropriate staff and remain in their review queue until it
comes up for review.
3. Technical Compliance. Once an application is administratively complete, it is routed to technical staff for compliance
review. Depending on the type of project, technical staff may include multiple reviewers. You should be contacted by
phone, fax, email, or mail by your TARGET DATE once the initial technical compliance review is complete.
4. Permit Issuance. When the technical compliance review of the application is complete, including any subsequent re -
submittals, each reviewer will approve their section of the application and route it to the Permit Center. When all sections
of the application are received, a Permit Specialist will process the application and contact the person specified on your
application for permit pick-up. Information regarding fees and pre -construction meetings (if required) will be provided by
the Permit Specialist at that time.
WHITE -APPLICANT PINK - BUILDING FILE REV 9/07
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McCullough Home Center inc
2300 w Broadway
Moses Lake, Wa 98837
509-765-1888 fax 509`765-1889 wide
28 home
utility locations " pull measure nents from upper left corner
from end from side
1, water '
, power
3, drain
4, gas
drain from round to be min of 8' from droof home
> < $4" >< 76 > <5Q >
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A
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w
model*
length*
width*
all centers must be filled with approved fill to top of concrete
slab to be 6" thick min, steel size and placement according to local code
slab should be B" longer than print length of home
this drawing is an example drawn by McCullough Home Center
inc,and may not meet local code in your area, please check your local
code for specific requirements in your local area.
"note, we do all tie down installation at time of set up"
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