2002, 06-14 Permit App 02004794 Relocate MHProject Number: 02004794 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
MANUFACTURED HOME
Setbacks: Front 5 Left: 5 Right: 5 Rear: 5
Site Information:
.......................................................
Plat Key: 000000 Name: UNKNOWN
Date: 6/14/2002 Page 1 of 2
Contact: SMITH, KENNETH W
Address: P.O. BOX 841
C - S - Z: TEKOA, WA 99033
Phone: (509) 998-6441
Group Name:
Project Name:
District: H
Parcel Number: 45094.6060M Block:
Lot:
SiteAddress: 11920 E MANSFIELD AVE #06 Owner: Name: SMITH, KENNETH W
SPOKANE, WA 99206 Address: P.O. BOX 841
Location:: SPO TEKOA, WA 99033
Zoning: UR-7
Water District:
Urban Residential-7
Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information: . ..
Review
Plan Review
Special Reviews
Permits:
t
i)et ()VT
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: 6/14/2002
Project Number: 02004794 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes: :::._. __...........................
Payment Summary: >;:.....
Permit Type
Manufactured Home
Date: 6/14/2002 Page 2 of 2
Fee Amount Invoice Amount Amount Paid Amount Owing
$0.00 $61.00
$61.00 $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 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 contrued 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: 6/14/2002