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2006, 06-13 Permit App: 06002273 MHProject Number: 06002273 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 06/13/2006 Page 1 of 2 Project Information: Permit Use: 1978 MOBILE HOME Contact: A & R MOBILE HOME SETUP Address: 1506 S DECAMP DR C - S - Z: SPOKANE, WA 99223 Setbacks: Front Left: Right: Rear: Phone: (509) 536-7847 Group Name: Site Information: ..,_ Project Name: Plat Key: Name: LABERRY MOBILE PARK ADD District: East Parcel Number: 55173.2511 Block: Lot: SiteAddress: 18912 E BLOOM CIR Location:: CSV Zoning: UR -7 Water District: Urban Residential -7 Area: 13,200 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Owner: Name: STALLING, LLOYD V & JONI M Address: 17209 E 4TH AVE SPOKANE VALLEY, WA 99016 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Building Plan Review Released By: per manufacture's specifications Originally Released: 06/13/2006 By: a_blake Driveway/Approach Released By: existing Septic Sys Review Originally Released: 06/13/2006 By: a_blake Released By: maximum 2 bedrooms Originally Released: 06/13/2006 By: a_blake Operator: AMB Printed By: AB Print Date: 06/13/2006 Project Number: 06002273 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 06/13/2006 Landuse/Zoning/HE Conditions Permits: Page 2 of 2 Released By: r Originally Released: 06/12/2006 By: KKENDAL Manufactured Home Contractor: A & R MOBILE HOME SETUP INC Address: 1506 S DECAMP DR SPOKANE, WA 99223 Item Description INSPECTION FEE Notes: Firm: Phone A & R MOBILE HOME SETUP INC (509) 536-7847 Units Unit Desc 2 # SECTIONS Permit Total Fees: Fee Amount $100.00 $100.00 MAXIMUM 2 BEDROOMS Payment Summary: Permit Type Fee Amount Invoice Amount Manufactured Home $100.00 $100.00 $100.00 $100.00 Amount Paid Amount Owing $0.00 $100.00 50.00 $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: AMB Printed By: AB Print Date: 06/13/2006 Project Number: 06002273 , Inv Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 6/12/2006 Page 1 of 2 Project Information: Permit Use: 1978 MOBILE HOME Contact: A & R MOBILE HOME SETUP Address: 1506 S DECAMP DR C - S - Z: SPOKANE, WA 99223 Setbacks: Front Left: Right: Rear: Phone: (509) 536-7847 Group Name: Site Information: Project Name: Plat Key: Name: LABERRY MOBILE PARK ADD District: East Parcel Number: 55173.2511 Block: SiteAddress: 18912 E BLOOM CIR Location:: CSV Zoning: UR -7 Urban Residential -7 Water District: Area: 13,200 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Lot: Owner: Name: STALLING, LLOYD V & JONI M Address: 17209 E 4TH AVE SPOKANE VALLEY, WA 99016 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Building Plan Review Released By: - -_ Driveway/Approach Released By: =. Septic Sys Review tcated 19(13101° Landuse/Zoning/HE Conditions Permits• Released By: - Operator: AMB Printed By: AMB Print Date: 6/12/2006 06/12/2006 13:10 • 5093241567 JL' 12 2006 1G:59 FR Project Mini x r: 06002273 Inv: 1 SRHD EI -15 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Praleatifentgfion: PAGE 01/03 TO 3241567 P.01/03 Date: 6/12/2006 Page 1 of 2 Permit the: 1978 MOBILE HOME Contact A & R MOBILE HOME SETUP Address: 1806 S DECAMP DR C $ Z: SPOKANE, WA 99223 Setback;: Flom Left Right: Rear: Phone: (509) 536-7847 Group Name: Site in rn gom. Project Name: sow we. Plat S,ey Niune: LABERRY MOBILE PARK ADD -"P—ar-c-e Frinbar: 551731511 Block: Lot District East :41reAddress: 18912 E BLOOM CIR Om: Name: STALLING, LLOYD V itz JONI M Address: 17209 E 4111 AVE SPOKANE VALLEY, WA 99016 Location:: CSV Zoning: UR -7 Urban Residential -7 water District Area; 13,200 Sq Ft Width 0 Nbr 01B1dgs: 0 Nbr of Dwellings: 0 Review illamagoili ..11M Build:ng Ems Review Hold: P Depth: 0 Right Of Way (ft): 0 Dill.' way/Approach • Sept: Sys Review ,1§40seT SEWAGE SYSTEM DESIGNED FOR Jr dase/Zoning/RE Candidata Pm*: • Op ex; Itqr: AMB PrincdBy AMB JUN 12 2006 14:29 PrintEMM: 6/12/2006 5093241567 PAGE.01 Jun 12 06 08:18a Sunrise Elementary Voce- Z o -F Yet.',T Aq\tca.4'ar Good morn;r�_ ©n n. 1 w0S i+•. noun ar -}v 5e_A- -k-ho.sc.-Corn-Ls. _ \Lad a\{r�to�a7 Fla�en race -I c�oW �1 -44,4 F+ea14� 1-.�iS�r CT O-f'-�' �\e -\\ Ls. nc\c— �-o Cc 1/2-4 rw 4-rcoc wou\ d 10.e_. no 'j t.est�Ms• Ort hS C�o1. �r qo-V 1; 4\c Co.* o \ J O t ccrmi� is Soreer sf� or kOa.Oct Ire S, Jam, w•\1 p�evlc our o F l iC_e S\hert1•1-"1-er cC jou. Y2 Celve ;4- , Ctir,a 1,0w re, v.Gk ;I W\ Cos. Alm,, rr -,.a . .•. C �. ., 3 C o Go�n'1•�� f vv. ` 1 T r\ctn S S o mUCL 509 228 4618 \ Q 4y_ —2 Q„ a 3 \\04-4,:s 6�\; car Ove an CI S 1 C o44;Cc abouck- c2 we p.1 L—iz-oL C; 1► fl,o.., q s t— ra JUN 12 2006 08:49 509 228 4618 PAGE.01 £0'30dd 8194 822 60S °et ++/ ;a' ) PLAN. G D T. APPROVED BY aft gtS4. �1 DATE. (9/1 s>,.-4b9r-F�Z'.s firCt rrn r °'< 54:80 9002 2T Nnf -44—eart. 't. ,,,. cin S .-r a • t 0 41n --a J 4 v t^ ^'t'1y v rn Cu cies S Q L S th... a ...yam---,-- -1--i,'?!-,-n,::•+ 0 1 - Y .1 U y d ^<.�• y�• O /\ c Is V 6•d OCIW* 'VM 'GH NVWHSIO 'S ZiB S213Q11fB AB 11VA 1S3M. 9194 822 8OS 1 4— \-o oloyb d SyAnt-aat9 (OP, �el� s� s "pro ,�, Ore•'rlh23/ *rod9 )(F9. !i ,•, Or? `. Syg Rueluewal3 est -ung e8T:80 90 2T unC RETURN ADDRESS LLOYD V. STALLINGS 18912 E. BLOOM CIRCLE SPOKANE VALLEY, WA 99016 WASHINGTON STATE DEPARTMENT OF Manufactured Home t11l LICENSING. Application Anyone who knowingly makes a false statement of a material fact is guilty of a felony, and upon conviction may be punished by a fine, Imprisonment, TITLE REMOVAL (RCW rE Zeilla AQeJ141 ELIMINATION IMIN IN LOCATION FROM REAL PROPERTY 46.12.210) ■TRANSFER • or both. 1` MANUFACTURED HOME TPO / PLATE NUMBER S ye75-4C/l YEAR 1978 MAKE CNCHM LENGTH/WIDTH(FEET) 68 X 28 VEHICLE IDENTIFICATION NUMBER WIN) MU202349 2 LAND LEGAL DESCRIPTION ON PAGE 2 MANUFACTURED HOME WILL BE E AFFIXED EtAFFIXED LS PROPERTY TAX PARCEL NUMBER 55173.2511 IN REMOVED LOT 11 BLOCK 6 PLAT NAME OR SECTION/TOWNSHIP/RANGE LABERRY MOBILE PARK QUARTER/QUARTER SECTION 3 GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER Lloyd V. Stallings STA LLLV4'74T2 NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER Joni M. Stallings STALL -TM 471 PS ADDRESS CITY STATE ZIP CODE 18912 E. Bloom Circle' Spokane Valley WA 99016 NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER Wells Fargo Bank, N.A. NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITU STATE ZIP CODE 2040 S. Eagle Road, Ste 2040 Meridian ID 83642 GRANTEE NAME 100 SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT,NI VEHICLE AND THIS INFORMATION IS ACCURATE: Signature of Registered Owner and Title, IF APPLICA Signature of Additional Registered Owner and Title, IF APPLICABLE WE / ` ri.Aria AM/A' E T '611411101.1 E REGISTERED CC -E. OWNER(S) OF THIS ,— 777 71;111111.1b NOTARY SEAL OR STAMP I Ite PU OI V 4iASHIPRINTAMEOFREGISTERED Enby- "N SEPTEMBER 1.9, 200c NOTARIZATION/CERTIFICATION of Washington County of i d Y FOR REGISTERED SPOKI1ME OWNER(S) Signed or attestedJULIEA.STIR before SIGNATURE onNOrTAR1Y 5tallin 5 SignatureSTATE O�NERN Joel M. swung, JUllr A NAME OF County/Office AND- Notary NTCOMMISSION Sint19 NOTARY No. OR 9 7.ave Dealer No OR PRINT NAME OF REGISTERED 0 PRINTED � triri , I p d FW17-1 POY NLENTNOT Title DEALERSHIP POSITION/AGENT/NOTARY Expiration Date 4 TITLE COMPANY CERTIFICATION I certify that the legal description of the land and ownership is true and correct per the real property records NAME (TYPED OR PRINTED) TITLE COMPANY / PHONE NUMBER SIGNATURE / POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. '5 BUILDING PERMIT OFFICE CERTIFICATION I certify that: 0 the manufactured home has been affixed to the real property as described 0 a building permit has been issued for this purpose and the attachment will be inspected upon completion. NAME (SVPED OR PRIN D) BLDG PERMIT OFFICE/PHONE N 1,‘ C. Z) - 005G, BLDG PERMIT X %(%co2Zl3 �'znn(. SIG ATURE/POSITION �/�,-_��) \(�J \ \ DATE virs, ksr iPICri TO, 20 TRl6/06)W Pa I oli✓\.,—