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2002, 11-20 Permit App 02010431 MHProject Number: 02010431 Inv: 1 Site Information: Plat Key: 005922 Name: SONRISE PLACE MANUFACTURED PARK District: Application THIS IS NOT A PERMIT Date: 11/20/2002 Page 1 of 2 Penalties will be assessed for commencing work without a permit Project Information: Permit Use: NEW DOUBLE WIDE MANUFACTURED HOME Contact: ALL SEASON CONSTRUCTION Address: 34292 HWY 41 C - S - Z: OLDTOWN, ID 83822 Setbacks: Front 5 Left: 5 Right: 5 Rear: 5 Phone: (208) 437-3837 Group Name: Project Name: Parcel Number: 45092.9014 Block: Lot: SiteAddress: 11303 E JACKSON RD #057 SPOKANE, WA 99206 Location:: SPO Zoning: UR-7 Water District: Urban Residential-7 Area: .00 Acres Owner: Name: PUTNEY, TERRY Address: 11303 E JACKSON #57 SPOKANE, WA 99206 Hold: 0 Width: 70 Depth: 80 Right Of Way (ft): 50 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Plan Review Released:By: Manufactured Home Contractor: ALL SEASON CONSTRUCTION Firm: ALL SEASON CONSTRUCTION Address: 34292 HWY 41 Phone: (208) 437-3837 OLD TOWN, ID 83822 Item Description INSPECTION FEE COUNTY SURCHARGE Units Unit Desc 2 SECTIONS 1 Y OR BLANK Fee Amount $100.00 $22.00 Permit Total Fees: $122.00 Operator: RMB Printed By: RMB Print Date: 11/20/2002 Project Number: 02010431 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/20/2002 Page 2 of 2 Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Manufactured Home $122.00 $122.00 $0.00 $122.00 $122.00 $122.00 $0.00 $122.00 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: RMB Printed By: RMB Print Date: 11/20/2002 SPOKANE COUN Y PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: j/ e,;, (Ter C 1�f4/✓ v e Assessor's Tax Parcel Number(s): LIScet ci o uf Legal Description: Project Description: ITZA O Building Permit O Change in Use O Grading Manufactured Home Permit O Relocation O Sign D Tenant (New/Change) 0 Other Department Use Only Water District/Purveyor. Sewer District/Purveyor Road width Setbacks Front Rear: Left Right School District Fire District Zoning OWNER/APPLICANT INFORMATION Ei Indict,* who should be Ionia* r� rl �urdin_ Ibis Arrriecl 0 Owner. Phony. GZJy (�742aCa Fra: J�JApplicant:�2 Phone: Te�7 y / /i4 !v f ra.: laJmg Addre>:: / S7 //303 E' c%oci�ex94.-e Mailing Address: 3Y222 c 7 J / Cite, State, Zip :-6'r , 924(z" City, State, %+ /��� D ��y d% t� ontnetor Phone y,. C Phone ❑Architect/Iinsd Architect/Engineer //I���Z 2� fay �[� .SLe� " 7//C�✓i- C7 Fax Mailing address Mailing address City, State Zip City, State Zip WA State Contractor license # r,/���5 /Z.-2—� Contact name: PROTECT INFORMATION Building Information Building height to peak # of stories Main floor sq. ft. Unfinished basement sq. ft. Dimensions- Totalhbitable space %S /) 2i1 floor sq. ft. Finished basement sq. ft. Occupancy group ' Construction type Garage sq. ft. 1)eck sq. tr. Cost of project Beat source (electric, gas, etc.) Manufactured Home Sign Width: Length: What is the square footage of the sign face? 1-Iow high is the sign? Year: Male:-. D / fr2 # of signs Arca of existing signs ,eglied- Relocation Fire Safety Previous address Fire Sprinkler Tent Paint booth 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 ❑ Bolting ❑ Reinforcement ./7 / Address /7--%4 7 'eV- f ADD4Ti0NAL SITE INFORMATION Are there structures on the property? ❑ Yes ❑ No If yes, identifj; 0/1 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, identifir on site plan ❑ Yes ❑ No What is the current use of this property? Is your property in a designated wildlife habitat area? ❑ Don't know ❑ Yes ❑ No Will the site be served by a septic system? ❑ Yes ❑ No Is any part of the property within a 100 yr flood plain? Ifyes, ident6, on site plan ❑ Maybe ❑ Don't know ❑ Yes ❑ No Are or will there be wells located on the property? Ifyes, ident5' on the site plan ❑ Yes ❑ No Are there any wetlands, streams or ponds within 200 feet of the property? If yes, identifjr on site plan ❑ Yes ❑ No Is there evidence of fill or excavation on the property? ❑ Yes ❑ No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( / °yo) 0 Yes 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? O Yes ❑ No Is public sewer available to the site? 0 Yes 0 No Is the property inside the ASA? 0 Yes 0 No O Yes ❑ No Is public water available to the site? 0 Yes 0 No Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? ❑ Yes ❑ No Date Received: Staff Representative: METHOD OF PAYMENT ❑ CASE I ❑ CHECK ❑ .1E2MIN ❑ VISAZ.-- 1IcwE'; FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: I i\131 AES: BANKCARI NUMBER: AUTHORIZED SIGNATURE: SUB'I'oTAL TOTAL FEE MINIMUM PERMIT FEE IS $3S.00PLEASE MAKE CHECKS PAYABLE TO SPOKANE COUNTY PERMIT CENTER