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2003, 10-21 Permit: BLD-03-02840 MH Placement #21Spokane Valley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 MANUFACTURED HOME PERMIT Job Address: 4415 N ADAMS RD #21 #21 SPOKANE WA 99212 Description: SINGLE WIDE MOBILE HOME 302-/\ Permit #: BLD -03 -02840 Applied: 10/21/2003 Issued: 10/21/2003 Expires: 04/18/2004 Subdivision: Lot: Blk: Parcel No: 45022.6109M Zoning: Owner: WALDEN, NEIL Applicant: WALDEN, NEIL Phone: (509) 928 -4595 Address: 4415 N ADAMS RD # A -12 SPOKANE VALLEY, WA 99216 Contractor: Phone: Address: Lic No: General Information: Fees: SECTIONS 1w PER SECTION FEE 50.00 YEAR BUILT 1959 DIMENSIONS 10 X 45 Total Calculated: 50.00 MANUFACTURER REX Deposits /Receipts: 50.00 Total Due: 0.00 Disclaimer: 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. Ownership of resulting development rights granted by any issued permit inure to the property owner. _ 0 CSC. ( c 3 Print Name Signature Date Staff Initials THIS IS NOT A RECEIPT