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2007, 02-02 Permit App 07000325 Set MH
Project Number: 07000325 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: PIT SET 1998 FLEETWOOD MH 27 X 52 Setbacks: Front Site Information: Plat Key: Left: Right: Rear: Name: Range Date: 2/2/2007 Page 1 of 2 Contact: STREBECK, DON K & SILVIA Address: PO BOX 142123 C - S - Z: SPOKANE, WA 99214- Phone: (509) 994-9292 Group Name: Project Name: 1998 FLEETWOOD MH-27 X 52 District: East Parcel Number: 55082.0503 Block: SiteAddress: 19004 E MARIETTA AVE Location:: CSV Lot: Owner: Name: STREBECK, DON K & SILVIA Address: PO BOX 142123 SPOKANE, WA 99214- Zoning: UR-7 Urban Residential-7 Water District: 134 CONSOLIDATED ID #19 Area: 10,085 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Building Plan Review Septic Sys Review c��eti 21 �-* *[) Hold: ❑ Depth: 0 Right Of Way (ft): 0 Released By: Released By: Landuse/Zoning/HE Conditions Permits: Contractor: OWNER Item Description INSPECTION FEE Manufactured Home Firm: OWNER Phone: Units Unit Desc 2 # SECTIONS (000) 000-0000 Fee Amount $100.00 Permit Total Fees: $100.00 Operator: jmm Printed By: jmm Print Date: 2/2/2007 Project Number: 07000325 Inv: 1 Application Date: 2/2/2007 Page 2 of 2 Notes: THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit 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: jmm Printed By: jmm Print Date: 2/2/2007 02/05/2007 10:58 5093241567 SRHD EHS FEE 02 2007 14:24 FR COSV PERMIT CENTER 5096880037 TO 324156? rriuc ul/ uc P.01/03 Project Nu rr her. 07000325 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Prefect Ir. jtlrrnationa Permit ils<,: PIT SET 1998 FLEETWOOD MR 27 X 52 Setbac ks front Left: Right: Rear: Pe Info r as.atjon: Plat K e: r; Name: Range Ftrc:l Number: 55082.0503 Block Date: 2/2/2007 Page 1 of 2 minteatuanormsesegamuulaireur Contact: STREBECK, DON K & SILVIA Address: PO BOX 142123 C - S - Z: SPOKANE, WA 99214- Phone: ($09) 994-9292 Group Name: Project Name: 1998 FLEETWOOD MH-27 X 52 Lot: District: East S iteAddress: 19004E MARIETTA AVE Owner: Name: STREBECK, DON K & SILVIA Address; PO BOX 142123 SPOKANE, WA 99214- Location:: CSV Zoning: UR-7 Urban Reeidenda1-7 Water District 134 CONSOLIDATED ID #19 Hold: 0 Area: 10,085 Sq Ft Width: 0 Depth: 0 Right Of Way (f!): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Revie»' 1;10 rnatien Eau Built ng Plan Review Septic Sys Review S ;Wli SYSTEM ((D99,e5RG D FOR_ way. Lanrlcse/Zoning/11E Conditions One Contract or OWNER ltaw i?t Tiption INSP?( ION FEE Operator Jmm ReletteatfByr' I f' R,el r7,; • ►mac..-, MagtUhctured Howe _. —.--- Firm: OWNER Phone: (000) 000-0000 Units Unit Des_C 2 # SECTIONS Printed By: Juan Fee Amount $100.00 Permit Total Fees: $100.00 Print Date: 2/2/2007 FEB 05 2007 10:53 5093241567 PAGE.01 02/05/2007 10:58 5093241567 SRHD EHS FI=E 02 2007 14:24 FR CCSU PERMIT CENTER 5096880037 TO 3241567 PAGE 02/02 P.02/03 Project No rr ber: 07000325 Inv: 1 Notes: Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Pei melt; t .!'i rmmary: 1zi1Type Mtmt f icttt.red Home F€e,Amoiint lWQi LAmount S100.00 S100_00 $100.00 $100,00 Date: 2/2/2007 Page 2 of 2 Amount Paid , ,t Owning $0.00 $100.00 $0.00 $100.00 Submit till of thls application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contain al I within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be eompli� d 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 pro ri;ions of the code or of any other state or local laws or ordinances. Sigmas ra OperAti .r jmrn Printed By: j mm Print Date: 2/2/2007 FEB 05 2007 10.53 5093241567 PAGE.02 7 i 2'1 teC '7U` r 3 14) / 9P-i9 E /'M/(i ors" 1 5'7 ` �. ��TY� Permit Center Sp©1 ne 11707 E Sprague Ave, Suite 106 [ fl \,j { Spokane Valley, WA 99206 D ,�,,,.•I"� `Tal le t.B 01 2007 (509)688-0036 FAX: (509)688-0 Community Development wa'w.spokaneva1 ey.or Manufactured Home Permit Application n I' OTHER PERMIT NUMBER: PERMIT FEE: SITE ADDRESS: ! 0OVI/ 4/e/6-- A -y ,4✓,--_, o}, s ‘ A 472,6, 09-, q9'Z 7 ASSESSORS PARCEL NO: S-JTZ.) 2- ST 3 Building Owner: Name: ©N S-�2G/3 c� 6.1G Address: 49, ec,k //D 7.-- City: r S O/ecA' -<e.t'S State: 4.0/4. Zip: 027 Phone: 'q _ 5---; c Fax: _0_. Contact Person Name: %JDJu Sfj Phone: eE// 99 `7 �--9� 9)2-- Describe the scope of work in detail: LEGAL DESCRIPTION: Contractor: Name: .©„,) 5�2��e4 e---/<- Address: ..- City: State: Zip: Phone: Fax: Contractor Lic No: Exp Date: City Business Lic. No: MANUFACTURED HOME Width: 2-7 Year: /9g Manufacture: %/EE /jez9re 6' Previous Address: Proposed Use: Length: S2_, Septic/Sewer: 5 50f c 7�u/�lE l), s -/ fLi. 4 z 5 / Pit Set: 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 ❑ Check Bankcard #: Authorized Signature: REVISED 8/23/2005 ❑ Mastercard Expires: Date .---- a/— 67 ❑ VISA VIN#: q lw �/ /yl ^el cam,; H 0 0 a 0 spa V;c1.-L) 1;Avs