2008, 06-03 Permit App 08001895 Set MHProject Number: 08001895 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 1985 27 X 52 GUERDON - PLACED YEARS AGO
W/OUT PERMIT
Setbacks: Front 46 Left: 15 Right: 31 Rear: 23
Site Information:
Plat Key: 000077 Name: Range
Date: 6/3/2008 Page 1 of 2
Contact: STONE, CHARLES H & RUTH V
Address: PO BOX 141928
C - S - Z: SPOKANE, WA 99214
Phone: (509) 891-8734
Group Name:
Project Name: PERMIT NEEDED FOR TITLE
ELIMINATION
District: East
Parcel Number: 55192.1407 Block:
SiteAddress: 17318 E 4TH AVE
Lot:
Owner: Name: STONE, CHARLES H & RUTH V
Address: PO BOX 141928
Location:: CSV SPOKANE, WA 99214
Zoning: MF-1 MF MDR District
Water District: 134 CONSOLIDATED ID #19 Hold: E
Area: 8,508 Sq Ft Width: 71 Depth: 120 Right Of Way (ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review
Septic Sys Review
Released By:
Originally Released: 5/21/2008 By: LHALSEY
Landuse/Zoning/HE Conditions
Permits:
Released By:
Originally Released: 6/3/2008 By: kkendall
Contractor: OWNER
Item Description
INSPECTION FEE
Manufactured Home
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
2 # SECTIONS
Fee Amount
$100.00
Permit Total Fees: $100.00
Operator: JD Printed By: JD Print Date: 6/3/2008
Project Number: 08001895 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
Permit Type
Manufactured Home
Date: 6/3/2008 Page 2 of 2
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: 6/3/2008
05/.20/200B 18:31 15092556432 JUSTIN BENNETT REMAX
PAGE 01/04
*dime
.000Valley.
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.sgstanevallev.org
Manufactured Home
Permit Application
El OTHER
PERMIT NUMBER:
PERMIT FEE:
SITE ADDRESS: 17318 E. 4" GREENACRES
ASSESSORS PARCEL. NO: 55192.1407 LEGAL DESCRIPTION: LOT 7 BLOCK 3 APPLE VALLEY ESTATES FIRST ADD.
Building Osvner:
Name: CHARLES STONE
Address: 26417
MOONSHADOW
DR
City: SUN 1.,AKES
STATE: AZ
Zip: 85248
Phone:1-480-895-9720
Fax:
Contact Person
Name: JUSTIN BENNETT OR PAUL STONE
PHONE: 509-216-0997
1-310-550-6364
Describe the scope of work in detail:
Contractor:
Name: WORK IS
ALREADY DONE FROM
MANY YEARS AGO
Address:
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No:
Exp Date:
City Business Lic. No:
NEED FINAL PF,RMIT IN ORDER TO BE ABLE TO ELIMINATE THE TITLE
MANUFACTURED HOME
Width: 27
Length: 52
Year: 1985
Pit Set: NO
Septic/Sewer:
SEPTIC
anufacture: GUERDON
Previous Address:
Proposed Use: TO LIVE IN
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 Date
Method of Payment:
❑ Cash
Bankcard 0:
Authorized Signature:
❑ Check
❑ Mastercard ❑ VISA
Expires: VI N#:
Effective October 28. 2007
Page 1 of I
http://www.spokanevalley.orgiuplorulsi;nmmunityDevelormcnt/Dacumenis/lrorms/Dullding/Monolncunred Home NermitApp.doc
MAY 20 2008 18:36
15092556432 PAGE.01
05/20/2008 18:31 15092556432
f
JUSTIN BENNETT REMAX
SPHD GNVR HEALTH
PAGE 03/04
PALL 01/03
Address/Legal Description:
Subdivision/Block/Lot:
Remarks:
ta' raa
FINAL AS-BUI T INSTALLATION
l APpcat on J'
j '7,5
ndirS�/�' ne c1a.1 is !`: aL✓ fN/ba.�
/=Cv91f^tr-
Signatur
-- — f
Tar LOCATION of THE H.F
DN-SITE 9ErvASE
TO SE CONSTlxw O AS AN
EXACT LOCATION OF THE Sr9TEM
Septic Tank Sind"
Drainfielth jj
Leachbed:
Double Plumbing OYes
MAY 20 2006 16:37
15092556432
PRGE.03
PAGE 04/04
PAGE 02/03
05/20/2008 18:31 15092556432 JUSTIN BENNETT REMAX
4t)ob 14: d3 bt19-A24-3E03 ORI D ENNR HEALTH
APPUCATION FOR ON -SITE SEWAGE SYSTEM
Spokane Bounty Health District
Ere ronmantal Health Division
1101 West Collage Avenue
Spa son; WA 99201-2095 (509) 324-1590 Deily InspectIon Announce
nt
Application No.99-Dl:i."i4 rf
Aro* Tract:M
Date of Application: nafw/,taa
4-1581 krepet:den Cation: 2241E40
rltddrens et Lepel Deocrlptlon of Property. Town/Clty: Parcel Oh
z'AR 4TH AVENUE., BREENACREE WA 99016 55142.1407
Lapel Owner of Property: Adding: 17318 EAST 4TH AVENUE
MARLENE ENDRES
OREENACRBSt WA 94016-0000
SubdlvieionlelockALot: Property $izat
LY EC APPLE VALLEY ESTATES 1
Daytime Phone:
74120
nperty Use: Single -Family Residence:
3 Bedrooms Total
New system: Np •75V
What iA propeeed: DSeptic Tank No._i^Size:
DGrense Trap No.812e
C114oldlna Tank Nn. Size:
DOther • Speelfy:
EBISTINO
Property In batted wit in: ,SSA
inside ASA
Replacement for toliure/saturation:
E3po0ura-no record or pyotem/other:
Other:
Alteration - relooatekonrilat:
A (orpaon - ahanae of une:
tarn - edd-nn:
Yes
Carp:
U=Urbsn0
R0:Aural
C=Commeralal
S =Suburban
SR ncemr•Rurel
I ..InduatdM
7. =Incoi.
A r•ApatulturM
X - Other
Will tnie prepdnnl result In INCREASED sewage flow?
let use property witNn a community public Rower service erne?
If Yea, name of dlatdot/ayRtonn
Source of water:
No
Ed sting Public/shared water source - Name/ID# CONSOLIDATED
292 DOES MD lad
Contact: ?ARLENE ENDRES
Sionnure of Authorized Reproaentclly
e
of Phone:
ATTACHED PLOT PLAN DESIGNED BY:
Tgt5C-ENEPLE
504) 89 t D
le Reel Property Covenant required?
Nry
e = • rrespendenoe tot
173I8 EAST 4TH AVENUE
GREENADRES NA 99016
phone:
i�1+174:i41u(.r.:
Inspection Call -In Dates
Fee payments
Testholeea
emtpn:d
date
rep.*
check,
paid by;
Partial:
Application:
SO —
72Cl
1637
AC0 37
`ra,' one._
Ceroly-cs
e
Final:
r/�A
Permit:
//5-
1/
if
/1
Ae:nepactton:
292P Review:
E,.poMge:
Reinfection:
re"
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---
Other
AIt.Sya. limp:
Man Review:
—M--_
Renewal:
MAY 20 2008 18:37
15092556432 PAGE.04
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Site Address: 17318 E 4TH AVE
Parcel Number: 55192.1407
Zoning: MF-1
Fire District: FD 01
Project
Transmittal
City of Spokane Valley
Community Development
Department
11703 E. Sprague Ave, Suite B3
Spokane Valley, WA 99206
Phone: 509.688.0036
New project
Previous pre-app meeting
Plan revisions El
Transmittal Date:
Wednesday, May 21, 2008
Project Number: 08001895
Water District: CONSOLIDATED ID #19
Applicant: STONE, CHARLES H & RUTH V Owner: STONE. CHARLES H & RUTH V
PO BOX 141928 PO BOX 141928
SPOKANE, WA 99214 SPOKANE, WA 99214
(509) 891-8734
e-mail: e-mail:
Contact: STONE, CHARLES H & RUTH V Occupant:
PO BOX 141928
SPOKANE. WA 99214 e-mail:
(509) 891-8734
e-mail:
Contractor: OWNER
( ) - 0
Arch / Engineer:
e-mail:
Project 1985 27 X 52 GUERDON - PLACED YEARS AGO W/OUT PERMIT
Description:
Building
Landuse
Engineer
Utilities
Health
Fire Dist
Assessor
APPLICATIO
SITE PLAN
Please send all plan review and project comments via e-mail to the
highlighted individuals.