1986, 11-25 Permit: 00014347 MHSIGNATUREOF
OVVNERORAGENT /y
JOB ADDRESS
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,o8 N' AVALON ST
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�GCENBUCK/ BEVERLY J
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211 E ASTOR DR
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SPOKANE WA 99288
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CONTRACTOR:
1,:HJCCENBUCK, BEVERLY J
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.|i E ASTOR DR
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pOKANE WA 99208
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4308 N AVALON ST
APPLICATION
.
DATE
PROJECT #
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0
DATE: 1/25/86
00014347
MOBILE HOME $51.58
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$51.50
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MOBILE HOME PERMIT
MOBILE HOMES
Make Serial *
Number 1 Width 12 Length 58 Height 10
Misc Desc : BLDG SC
TOTAL FEE
Fee
Misc Fee
$51.50
50.00
1.50
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OFFICE COPY
DEPARTMENTAL REVIEW
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent J% compile said application is true and correct.
M
Signatur
GLt� —C Al Date
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Approved
Cond.
Approval
Hold
Environmental Health Application #
W. 1101 College
200
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_Room_
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Planning /Zoning
N. 721 Jefferson
Engineers
Jefferson
N. 811
Utilities
N. 811 Jefferson
Plan Review /Fire Prevention
N. 811 Jefferson
Other (SEPA /Critical Material /etc.)
Fast Track /Special Inspection Information
Protect Representative
Phone
Address
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent J% compile said application is true and correct.
M
Signatur
GLt� —C Al Date
//- .z s -- ,r4
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