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2014, 05-21 Permit App FAS-2014-0005 Replace MH016.1\sts, Siblane 4•0Valley. Community Development Department Permit Center 11703 East Sprague Avenue. Suite B-3 Spokane Valley, WA 99208-"'" 4"'' Tel: (509) 688-0036 Fax: (509) 688-0037 permitcenterPsookanevallev,orq (Staff Use Only) PERMIT NUMBER: PERMIT FEE: MANUFACTURED HOME PERMIT APPLICATION Cl OTHER SITE ADDRESS: I � l c d E c 1 1eic c e IPT�ON5?�k4Ne Valk! J A q/c' ASSESSORS PARCEL NO.: 15 (�ej , (o0r� I LEGAL DESC : �►rr�cv e r1 mr)hdP rar k BUILDING OWNER NAME: NAME: ?l N e,c Tf) i stif ADDRESS: Iq aD E. m, N S 1 1 plA QUr 146 A CITY: 5PSTATE: wIA PHONE: — 43 O 5-3 3 7 CONTACT NAME: T Are_5a PHONE: 5"09 - 38i 5337 CONTRACTOR NAME: MAILING ADDRESS: CITY: I .1)i) FAX: FAX: STATE: ZIp: 1 1 aoL 2 CELL: 1,4 16)�D CELL:' , E I " E D MAY 7 1 71114 CSV PERMIT CENTER PHONE: FAX: CELL: Ht<V, rr CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: MANUFACTURED HOME WIDTH: o� MANUFACTURED HOME LENGTH: YEAR OF MANUFACTURED HOME: I� PIT SET: EPTI SEWER: MANUFACTURER: PREVIOUS ADDRESS: PROPOSED USE: DISCLAIMER The permitted verifies, 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 of 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 be submitted and subsequently approved before this application can be processed. Date: j� , /II Signature el LA Lt A Le\A Updated 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/ 124/938/210/948/ 1496/Manufactured_Home__Permit_1-11-11.doc