1992, 06-25 Permit: 92004747 MHSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, oras a warranty of conformance with the provisions of any state or local
laws regulating construction
SIGNATURE OF A O . \�� APPLICATION 2- �C
OWNER OR AGENT 7•x�'(, v \\• DATE lJv l
PROJECT NUMBER= 92004747
ISSUED PERMIT DATE= 06/25/92 PAGE= 05
**************************** PERMIT INFORMATION *************
SITE STREET= 19004 E BLOOM CIR PARCEL:= 55173.2514
ADDRESS= GREENACRES WA 99056
PERMIT USE= REPLACEMENT OF DOUBLE WIDE MOBILE HOME / EXISTING SINCE 1981
PLAT:= 001407 PLAT NAME= LABERRY MOBILE PARK ADD
BLOCK= 6 LOT= 14 ZONE= UR -7 DIST.= G
AREA= 00000000 F/A= F WIDTH= .65 DEPTH= 105 R/W= 50
4 OF BLDGS= i 4 DWELLINGS= 1 WATER'DIST =
OWNER= MCKEE, WILLIAM 6 ALETHEA PHONE= 509 922 7374
STREET= 19004 E BLOOM CIR
ADDRESS= GREENACRES WA 99016
CONTACT NAME= WILLIAM MCKEE PHONE NUMBER=
BUILDING SETBACKS: FRONT= EXIS LEFT= EXIS RIGHT= F_XIS REAR= EXIS
****************************** MOBILE HOME PERMIT **************************
CONTRACTOR= OWNER PHONE=
YR/MAKE= 1978 COMCHEMCO MODEL=
SERIAL.= WIDTH= 28 LENGTH= 68 HEIGHT= 10
ITEM DESCRIPTION QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 18.00
*******************************
PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT) PAYMENT AMOUNT
06/25/92 4893 122.50
TOTAL DUE= .00 TOTAL PAID= 122.50
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME PMT 122.50
122.50
122.50 .00
122.50 a00
PROCESSED BY: JOHN LARSON
PRINTED BY: JOHN LARSON
******************************** THANK YOU *********************************
Manufactured Home:
Year 1978
Make COMCHE'ICO Width 28 FEET Length 68 FEET
Vehicle Identification Number 02286
1A1 �Qz-i ft�ti 12A,!
C- -CF
Names WILLIAM M S. ALETHEA A MCKEE Signatures' JJI Q 6.61.4/b
Registered Owners:
Legal Owners:
Names SPOKANE POSTAL CREDIT UNION
Signature&
Leee„p
'SIGNATURES OF OWNERS INDICATE TERMINATION OF INTEREST IN THE MANUFACTURED HOME THROUGH TITLE PROVIDED BY CHAPTER 46.12 RCW AND
INDICATE INTENT TO PERFECT INTEREST IN THE MANUFACTURED HOME AS REAL PROPERTY WITH THE LAND HE/SHE/THEY OWN AND TO WHICH IT IS/IS
BEING AFFIXED
Land to Which Manufactured Home is Being Affixed:
Property Tax Parcel Number 55173.2514
Legal Description LOT 14, BLOCK 6, LABERRY MOBILE PARK, AS PER PLAT RECORDED IN VOLUME 8 OF
-PLATS PAGE 63, RECORDS OE SPOKANE, CUUN'1'Yr/� /). jh
Owners' Names WILLIAM M & ALETHEA A MCKEE Signatures2 U_ )l.QOLetLt �Lt
'SIGNATURES OF OWNERS INDICATE CONSENT TO HAVE THE MANUFACTURED HOME ADDEO TO THE REAL PROPERTY LISTED ABOVE.
Building Permit Office Certification:
I certify that the manufactured home has been affixed to the real property as described above and/or building permit
number 9; — 5/2 92 has been issued for the purpose of affixing the manufactured home to the land and will be
inspected upon comple ion. SPOKANE COUNTY
SIGNATURE n1
BUILDING & SAFETY to _ �S y�
NAME
BLDG. PERMIT OFFICE
DATE
PHONE NUMBER
County Auditor/Agent Licensing Office Approval: (Not for use by subagents)
I certify that the above application appears to have been completed correctly, and that the applicant has sufficient
documentation to proceed with the recording of this form.
NAME
SIGNATURE
OFFICE:CAAP OPERATOR NUMBER
DATE
Recording Office:
I certify that this form has been recorded in the county records.
NAME
SIGNATURE COUNTY DATE RECORDING NUMBER
Note: Every person who falsifies or intentionally omits material information required in an affidavit is guilty of a gross
misdemeanor punishable in accordance with RCW 9A.20.021.
TD -420.730 MFG HOME TITLE ELIM (N/1/90) Page 2 of 2