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1995, 08-28 Permit App: 95006717 MH• APPLICATION INFORMATION What is the JOB SITE address? ASSESSOR'S tax parcel number? Legal description as it appears on the property deed /5 04 e -'ea OWNER or OCCUPANT Phone Mailing address /7" City, state - Zip Who should we contact regarding this project? - 42' a -t- -1. What work is being clone/under this permit? Phone 40t1*. • - • . . • Inspector district • • • ••.,. Property size l'irght of way width Water • . . .... • disfrlct, :•- Contractor Building height Dimensions # of stories TOTAL SQUARE FOOTAGE WA State Contractor license # Main floor area Unfinished basement area Mailing address 2nd floor area Finished basement area Architect/Engineer Garage area Size of decks, etc. What is the heat source? What is the cost of your project? Manufactured Width: Length: .2 - What is the square footage of the sign face? How high is the sign? 0 D Make: /- L t Installer 2.77" ) Wa State Contractor license Year: Contractor Wa State Contractor license # Mailing address Mailing address Relocation Fire Safety Previous address Fire Sprinkler Paint booth Fire Alarm Tent Fireworks display VALUE Contractor Contractor WA State Contractor license # WA State Contractor license # 0. 0 Mailing address Mailing address Fuel Storage Tanks Swimming Pool (Circle one) Above -ground Underground Contents of tank(s) Size / gallons Size / gallons Private Public/semi-private Contractor Contractor Wa State Contractor license # WA State Contractor license # Mailing address Mailing address COMPLETE ALL APPLICABLE INFORMATION Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities. PROJECT NUMBER= 95006717 APPLICATION DATE= 08/28/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 7921 E BEVERLY DR PARCEL#= 453.1106 ADDRESS= SPOKANE WA 99212 PERMIT USE= INSTALL NEW DOUBLE WIDE MANUFACTURED HOME PLAT#= 000568 BLOCK= 11 AREA= # OF BLDGS= 1 PLAT NAME= CURTIS PARK CLUB TRACTS 1ST AD LOT= 605 ZONE= UR -7 DIST#= F F/A= F WIDTH= DEPTH= R/W= 50 # DWELLINGS= 1 WATER DIST = SPO CO WATER DIST#1 OWNER= YARROLL, HELEN STREET= 7921 E BEVERLY DR ADDRESS= SPOKANE WA 99212 CONTACT NAME= YARROLL, HELEN BUILDING SETBACKS: FRONT= 05 LEFT= NAr 30 5' ****************************** REVIEW IN DEPARTMENT PHONE= 509 924 3514 PHONE RIGHT= -2 - 30 FORMATION *** REVIEW REQUIREMENT NUMBER= 509 924 3514 REAR= /5 BUILDING SETBACK REVIEW REQUIRED COMMENTS: C'met'P-I ENGINEER APPROACH/ DRAINAGE/ COMMENTS: HEALTHDIST COMMENTS: PLANNING COMMENTS: PLANNING COMMENTS: FLOOD b To P— MogILE IJoY qt7gridel NEW OR ADDITIONAL WASTE WATER � (tikacit INADEQUATE FRONT YARD SETBACK N/4- IVB=t.> SITE Put -kr SUA,M ITS sEr,B4C-- 71-Cea sf- /l-bB tc-Nor 6A- -e INADEQUATE FLANKING ST SETBACK 6A -me AS A-ogove. PROJECT NUMBER= 95006717 APPLICATION • DATE= 08/28/95 PAGE= 02 ****************************** MOBILE HOME PERMIT ***************************** CONTRACTOR= OWNER YR/MAKE= 1995 WINFIELD SERIAL#= ITEM DESCRIPTION PHONE= MODEL= WIDTH= 24 LENGTH= 60 HEIGHT= 10 INSPECTION FEE STATE SURCHARGE COUNTY SURCHARGE PERMIT TYPE MANUFACTURED HM PROCESSED PRINTED ********** QUANTITY 2 Y Y FEE AMOUNT 100.00 4.50 18.00 FEE AMOUNT AMOUNT PAID AMOUNT OWING 122.50 122.50 BY: JOHN LARSON BY: JOHN LARSON . 00 . 00 122.50 122.50 J5 -5Z; ********************** THANK YOU ************************************ PROJECT NUMBER= 95006717 APPIALLBZIOZ;7• DATE= 08/28/95 PAGE= 01 T ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED ,FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 7921 E BEVERLY DR PARCEL#= 453.1106 ADDRESS= SPOKANE WA 99212 J9' PERMIT USE= INSTALL NEW DOUBLE WIDE MANUFACTURED HOME PLAT#= 000568 PLAT NAME= CURTIS PARK CLUB TRACTS 1ST AD BLOCK= 11 LOT= 605 ZONE= UR -7 DIST#= F AREA= F/A= F WIDTH= DEPTH= R/W= 50 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = SPO CO WATER DIST#1 OWNER= YARROLL, HELEN STREET= 7921 E BEVERLY DR ADDRESS= SPOKANE WA 99212 PHONE= 509 924 3514 CONTACT NAME= YARROLL, HELEN PHONE NUMBER= 509 924 3514 BUILDING SETBACKS: FRONT= 05 LEFT= DM"RIGHT=-2 REAR= 3 0 5 " 30 /5 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING SETBACK REVIEW REQUIRED COMMENTS: ENGINEER APPROACH/ DRAINAGE/ FLOOD COMMENTS: HEALTHDIST COMMENTS: OK F-0 r- MoP,u 1JoY ct-!8 -95 5 #7.176? r I 4/ G./�.itPPI` NEW OR ADDITION WASTE WATER PLANNING INADEQUATE FRONT YARD SETBACK�NO- iv=,)SITE iLJ'4Jc Si IT-reo COMMENTS: SET'S k A -D (-ATE T / Bit -E• -/\.I©T 4A-eiv=e PLANNING INADEQUATE FLANKING ST SETBACK Aov COMMENTS: El Please XXX STATE Of WASHINGTON DepartmentofNAME MANUFACTURED HOME IICEflSIflG APPLICATION check one TITLE ELIMINATION (Complete all but section 3, below) TRANSFER IN LOCATION (Complete ALL sections below) REM VAL.FROM REAL PROPERTY (Complete all but section 4, below) RECORDER'S CLOCK FILED AT THE REQUEST OF: NAME ` _ °'�`'-D ADDRESS lo (o 1J UvotaJ to LI S (-f' )0-5 • © MANUFACTURED HOME TPO;PLATE NUMBER YEAR 1996 MAKE WINFIELD WIDTH'LENGTH 24' X 68' VEHICLE IDENTIFICATION NUMBER (VIN) 17709440-A LAND Attach a copy of the legal description of your land. It can be obtained from your County Assessor's office or it may be typed or printed on an Additional Attachment Form (TD -420-732). PROPERTY TAX PARCEL NUM BE 45193.1104/45193. 11('. Manufactured home will be [74 AFFIXED REMOVED © TITLE COMPANY CERTIFICATION I certify that the legal description of the land and ownership is true and correct per the real property records. NAME TITLE COMPANY/PHONE NUMBER SIGNATURE X DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. 1011 BUILDING PERMIT OFFICE CERTIFICATION f certify that the manufactured home has been affixed to the real property as described, or a building permit has been issued for this purpose and the attachment w�,b.e inspected upon completion. BLDGPERMIT. # l --ii 1 1 NAME ; n SIGNATUREJTITLE 51.OIKANECO X DIVISION OF BUILDING AND PLANNING BLDGPERMITOFF1GEIPHONEN I _lJ671,�_ 3 /1 �. DATE ,te ......5......5r �� OWNE INFORMATION FEES COUNTYrt INC UN INC ri U n REGISTERED OWNERS 1 rF LEGAL OWNERS 1 Provide the Washington Driver's License or I.D. card number (PIC) for each owner: FILING FEE R NAME OF FIRST OWNER ARLENE 11. LUMP ER LUMPEAIi536B2 APPLICATION O s NAME OF SECOND OWNER MOBILE HOME FEES E T R ADDRESS OF OWNER Beverly Drive --OR-- if (he owner is a business, ELIMINATION E o ' 7921 East CITY STATE WA ZIP COD E 99212 provide the Unified Business Identifier (UBI), found on the business Registration & Licenses USE TAX I Spokane NAME OF FIRST LEGAL OWNER' UNITED SECURITY BANK Document. SUB•AGENTFEES E H MAILING ADDRESS OF FIRST LEGAL OWNERMore 9506 N . Nowpo t l'wy than two owners or one lienholder? Please use attachment TOTAL FEES & TAX $ O CITY STATE ZIP CODE form(s) #TD -420-732. L E Spokane 1 WA 99218 DEALER'S REPORT OF SALE p. *SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMINATION O r F.-4-Fi J'VA FROM REAL PROPERTY: X I certify that this information is correct. The vehicle is clear of encumbrances except as shown. Anyone who knowingly makes a false state) - of a = eLiel fact is guilty of a felo y, and upon conviction may be punished by a fine of up to $5,000 and{cn10 yfetirsimprisonment WA DLR NO tai C2 DATE OF SALE -- rJ /may .Z/,-7, ,- PURCHASE PRICE - 7 7 LJ ( , I 5�r (RCW 46 12.210). I DO SOLEMNLY ATTEST UNDER Per TY OF PERJURY LAW THATI/WE ARE THE REGISTERED OWNERS OFTHI4. AND ,THIS(F IA- TION I CCUR TE: Owner Signa ure(s) & Ti e(s)::, zip � C7EALER NAME ( Womach's dome Sales, Inc. TAX JURISDICTION/TAX RATE r / (:' e1,GY so Q l� .p'. C rte► X 1 'Le----- T L . `i 43; k� 0. p ~' E •LER'S AUTHORIZED SIGNATURE ,----- eX is_ ` a.„ USE TAX EXEMPT Sale to a Certified Tribal member on . ; . ) i X the reservation (attach notarized statement of delivery) i Not/NH'Ifil.H,'LN:-:EA .t:NtB NU�if-}i 1d ..�.$lIR 5Cf3113E A1Qt� SWORN BE FORE ME THIS r� 0 Gt-? i � � �i t f ;Yds December 1995 Resid ing in (County) c0UNT - ,UDITOR/AGENNTTLLICENSING OFFICE"APPii3VAL: (Not for use by Sub -Agents) 1 certi:y that t e above application appears to have been completed correctly, and the applicant has sufficient documentation to with the recordin of this form. __proceed N4ME SIGNATURE X OFFICENFS OPERATOR NUMBER DATE TD -420-729 MANUF HOME APPL (R/2/94)M Page 1 of 2 PROPOSED WATER LINE SITE SITE PLAN FOR LOT 4 & 5, BLOCK 1, CURTIS PARK CLUB TRACTS PARCEL No. 45193.1104/45193.1105 ,DDRESS: E./79a/ BEve-e.c_ ZONE ue -7 ROAD WIDTH. SD FRONT 30 .OMMENTS. '''PNED BY r 1 5b FLANKING: 00 0 10 20 40 SCALE: 1"= 20' SHEET 1 OF 1 METRO ENGINEERING, INC. EAST 9616 MONTGOMERY SPOKANE, WA 99206 (509) 924-8065 5037-PD.DWG V: SITE