1999, 05-10 Permit App 99003928 MHProject Number: 99003928 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SINGLE WIDE MOBILE HOME Contact: HOBBS, J. CURTIS & MEGA
Address: 11920 E MANSFIELD AVE #04-1-3
Setbacks: Front 4 Left: 5 Right: 5 Rear: 5 C - S - Z SPOKANE, WA 99206
Phone: (509) 000-0000
Date: 5/10/99 Page 1 of 1
Site Information:
Plat Key: MH004 Name: PINECROFT MOBILE HOME PA District:
Parcel Number: 45094.6139M
SiteAddress: 11920 E MANSFIELD AVE # Owner: Name: HOBBS, J. CURTIS & MEGA
SPOKANE, WA 99206 Address: 11920 E MANSFIELD AVE #043
Location:: SPO SPOKANE, WA 99206
Zoning: UR-7
Water District:
Area: 0 Sq Ft
Urban Residential-7
Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Hold: 0
Depth: 0 Right Of Way (ft): 0
Review Information: ,,,5V.55~"55Mtm.mX55.tV,Z5A5.555-4V..,:.t3.5:550‘.5*AM54.z5A5w5r435%%Z. )%5•kt5tn'kz5k z "tkW55.5k-,A5,5•54z335,3 5M.N.M*":m''',5:r5":i:‘n,555tW.Z•rr.;',..Sz,..'-':.•‘'''"'Wr'.5.z5..
Department
BUILDING
Comments:
Review
Plan Review
BUILDING Special Reviews
Comments:
Per mi s:
f), Peirn, f
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
STATE SURCHARGE
INSPECTION FEE
COUNTY SURCHARGE
Payment Summary:
Manufactured Home
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 Y OR BLANK
1 SECTIONS
1 Y OR BLANK
Fee Amount
$4.50
$50.00
$11.00
Permit Total Fees: $65.50
Operator: CKF Printed By: CKF Print Date: 5/10/99
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Manufactured Home $65.50 $65.50 $0.00 $65.50
$65.50 $65.50 $0.00 $65.50
Notes: .
DEp . • TMENT OF
ALlERATIONIS) SHOWN BELOW
COMPLIANCE WITH RULES AND
HONES IN EFFECT AT THE TIME
Address
ASNINGTON
LABC".-1 -INDUSTRIES
HAVE BEEN APPROVED AS HAVING BEEN IN
REGULATIONS FOR MANUFACTURED MOBILE
OF APPROVAL. RCW 43.22.360.
an name
Ith an X).
:e. See list on reverse.
ce within 15 days.
Day time phone
( )
City
ALTERATION PERMIT
Do not complete shaded areas
i Permit #
117850
Invoice #
Insignia #
13aUo'
Date
State ZIP
J
Instal ler/Contractor/Dealer
I
Ad ress
Check the appropriate boxes In section A and sectio B.
A Commercial Coach
j Serial No.
Mobile Home
;Serial No. -Cz O
HUD No.
JRecreational Vehicle or ❑ Park Trailer
Serial No.
Model No. or Plan Approval No.
Phone
City
Contractor's registration number
State
ZIP+4
Imf
2_SL
Alteration Inspection (check appropriate boxes below) $
Air Conditioning/Heat Pump
Electrical
Electrical Appliances
Fire Safety
Gas Furnace
Gas Piping
Plumbing
Structural
Wood/Pellet Stove — —
Plan Review
RV Inspection Onginal Permit
Reinspection No. S
Technical Inspection S
Serial TioansIII : 9°898585 I
Q5/O7/1 99 14'3O
�trrPf}1Y—t—� — $
Note: This permit expires one year after date of purchase. (Non-refundable)
%Signature of a leant or rued representative —N Make check payable to: Dept. of Labor & Industries
`X - 1 FEES DUE $
Department use only
Request approved or j Request denied because of specific violations of Washington rules and regulations. Violations must
be corrected and reinspection requested within 10 days for recreational vehicles and 20 days for mobile homes and commercial coaches
of the notice of violation date. (This does not apply to technical Inspections). It Is unlawful to offer for sale, rent, or lease any
non -complying mobile home, commercial coach or recreational vehicle.
Included are forms required which must be completed and fees submitted before reinspection.
(Date Area office Inspector
F 226-012-000 alteration permit 10 fla
Pe White -Olympia Canary -Inspector Green -Contractor Pink -Purchaser Goldenrod -Purchaser
Total pages