Laserfiche WebLink
� MOBILE HOME PERMIT � � <br />CITY OF EVERETT BUILDING DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Electrlcal Permlt No. <br />Sewer Permit No. <br />Nater Pexmlt No. <br />Plunbing Pecmlt No. <br />F�rmit No. <br />Date <br />Fee <br />Mobile Hane Pazk Name C/ ( i�O j (� ��,� I� � Space No. �� <br />Moblle Hame Park Address ol � <br />Speclal Prcperty Use Pernilt Nunber <br />Park Ormer �,Uc <br />Malling Fddress <br />Moblle Hame Owner <br />Malling Address � <br />Home Manufactuter <br />Installer/Conttac <br />Address <br />Other buildings on the lot: �� � V \ <br />Phone `�� (n � .,���� . <br />, <br />� '� 5„� `'` �:,,�5� - <br />I.i � Phone <br />u ��� � � �, <br />, <br />) O �� `L' � <br />_ r e � 1 /7., ;� � MrNO�oh�n.r <br />��U7�.5 3��n <br />Registratlon No. <br />�AiEs 1. All addltlonal sttucture� requlce seperete bullding permits. (Storage building, decks, caiports, etc.) <br />2. Prlor to occupancy� the Building Department shall i�spect for confo:mance to the site plan approved by the <br />Plaming Oepartment. ' <br />3. 1111 mobile I�anes shall be set tp in compliance with the Washington State Mobile Home Installatlon laws (WI1C <br />296.150B.2W to 255) which are evailable at the Building Department. <br />PMK OWrER'S CEATIFICRT1017: , , <br />I 11GfiEE 411�D CEFiT?FY lIII1T THIS MOBILE HCME WILL BE SITUAlEO IN A MRMIER THAT WILL �IEET iFIE SPECIFIC REOUIREFIENiS OF THE <br />SPECIRL USE PEAMIT ISSUED FOfi THIS PPFiK AND TFIE MPI.ICNBLE PROVISIONS OF h� CITY'S MOBILE fiOFfE PMK CODE. <br />IF TIE INSTRLLER'S CQiTIFIClITION !IS SET FORTH IN iHIS F'6UAIT IS NOT SIGNED BY THE INSTALLEit� h1EN� BY SIGN1tJG 1HI5 <br />pFJtMIT, TIE SIGNIITCXi OF ifE PMK OWNEFt'S CQiTIFIG11I0N /ILSO RGREES AND G£FiTIFIES TO TfIE FOLLONING: (1) TfU1T TIiE MCBILE <br />FI�ME MlLI BE INSTN,LED-IN ACCQ1011NCE NIiH TfE REWIREMENTS OF iFf SPECIlII PF20PERTY USE FQUIIT ISSUtI] FQi THIS FMK P1A <br />TIE PPPLIG�BLE RE4�UIREMENTS OF TFE M{ISHINGION STATE M63ILE HOME INSTALLATION LAXS AND 7}IE CITY'S MOBIIE FIOFIE PMK CLDE; <br />PND (2) THlli TIIE MODILF fI0F1E MILL BE INSTPI.LED IN A WORKMlUJLIKE MFINNEIi. NOTHING H6iEIN IS IM�r�ED TO CHNNGE THE LEGIIL <br />RELATIOtSHIP BETWEEN TfE MOBIIE FiOFE OXNER� MOBILE HOME PFYtK OMNEH MD TFE INSTIILLER. <br />INSTFLLER'S CERTIFIC1171UJ: <br />DIItE � �� ( <br />I A(AEE 111A CIItT1FY 11il1i TIIIS IdOBILE IiQ1E XILI BE INSTALLEO IN ACCIXi011NCE WITii ThE REqUIRErENTS OF THE SPECIOL FitOP£RTY USE <br />FETiF1IT ISSUED FOfi 711[S PMK A�A TIIE MRICf�BLE REpUIRE1dENT5 OF TFiE MIISHINGTON STATE l70BILE IIOME ItISTRLL11fI0N LIIWS �tA lllE <br />CITY'S MODILE fiU4E PMK CWE. I FUiiHER AGREE AND CERTIFY THRT THIS MOF3ILE HOME IWLL BE ItSTALLED IN A WQiKF1lIPLIKE MIIMJER. <br />SI�,� DIITE <br />ns a er <br />--------------------------------------------------------------- <br />OFFICE USE ONf.Y BELOW THIS LINE <br />� <br />Setbacks: Front (� <br />Special condltlons or lnstructions: <br />Ppproved (or permSt issuance: <br />6/2B/87 <br />1980I1 <br />/J�� {�0�1/� �T�tF�'>' Mo'��� NMIE 5 r <br />Slde Slde Rear <br />'g' � �� � <br />ae <br />