2007, 04-30 Permit App 07001524 MHProject :dumber: 07001524 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 1986 28 X 56 MFH
Date: 4/30/2007 Page 1 of 1
Setbacks: Front 49 Left: 32 Right: 7 Rear:
Site Information:
Contact: TEEPLES, AUDI
Address: 8523 E BROADWAY AVE
C - S - Z: SPOKANE, WA 99212
Phone: (509) 927-8277
Group Name: 7 ( Z -%S C 1
Project Name:
Plat Key: 001288 Name: HUTCHINSONS ADD District: Nort
Parcel Number: 45181.1525 Block:
SiteAddress: 8605 E BROADWAY AVE
Location:: CSV
Zoning: UR 3.5
Water District: 005 HUTCHINSON
Lot:
Owner: Name: TEEPLES, AUDI
Address: 8523 E BROADWAY AVE
SPOKANE, WA 99212
Hold: ❑
Area: .00 Acres Width: 62 Depth: 311 Right Of Way (ft): 40
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information: --- -- --------
Permits:
Contractor: OWNER
Manufactured Home
Firm: OWNER
Phone: (000) 000-0000
Item Description Units Unit Desc Fee Amount
INSPECTION FEE 2 # SECTIONS $100.00
Notes:
Permit Total Fees: $100.00
Payment Summary:
Permit Type
Manufactured Home
Fee Amount Invoice Amount Amount Paid Amount Owing
$100.00 $100.00
$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: 4/30/2007
jUalley
®� Permit Center
S n okane 11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevallev.org
Manufactured Home
Permit Application
OTHER
PERMIT NUMBER: l5Zy
PERMIT FEE:
SITE ADDRESS: ,9 F6 /3'rcis C../c,Y
ASSESSORS PARCEL NO:
Building Owner:
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Name: 4cdt-a;, f �.p77,,
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Address: c g — � n ei,d 6v c\ f
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City: �it7/�,,Q I/Q,�n State: 4 Zip: 95-,7
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Phone: J , 7 ifa Fax:
Contact Person
Name: -e t •
Phone:
Gj
77
LEGAL DESCRIPTION:
Contractor:
Name: `���C-v'-. `
Address:
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No:
Exp Date:
City Business Lic. No:
Describe the scope of work in detail: n ja e dry nn evu fa cis 7yn nn�
MANUFACTURED HOME
Width: a�i
Manufacture:
Previous Address:
Proposed Use:
Length: f'
Year: /` j(f.A6'
Pit Set: y-D_s
Septi
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This 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.
Signature
Method of Payment:
Cash
Bankcard #:
Authorized Signature:
REVISED 8/23/2005
❑ Check
Date 9- 2-51 c 7
❑ Mastercard 0 VISA
Expires: VIN#:
PLANNING DEPT. APPROVED
BY(lKCtuv-
DATE: 51 3/ 0�
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