1991, 06-18 Permit: 91002574 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. 1 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 t provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE C2.J11 APPLICATION 6 J s7 - ?/
OWNER OR AGENT 1 � �c yri� DATE
PROJECT NUMBER= 91002574 IS tiUEO PERMIT DATE= 06/18/9i
PAGE- i'i't
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ADDRESS GRE::?:::NA+:::F<F:::`.:' LJi1 990-16
PERMIT iiSE:::: S:#:NG#...E WIDE MOB:#:i...E HOME
PLATO= 000499 P#'NAME=
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E:
BLOCK= LOT=
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AREA= 00000000 I ' ;' �:j -:: F" WIDTH= 1r}' } DEPTH= 186 6 =
•„• ,tt.. BLDG,`;-:: '! 0 DWELLINGS= 'j WATER DIET
OWNER= BURKE, , JEANNE:.
STREET= 1 '# '1 ':i WRIVERSIDE A ;, r-
F1I.jIiR"r.:.F',`. •• SPOKANE I.4A 99202
509 747 :3285
CONTACT NAME:. E.•i1 NE BURKE PHONE NUMBER— 509 747 :es
:-. RIGHT= 5 REAR::- a :,,•..,
BUILDINGBUILDINGSETBACKS:<:i: FRONT=FRONT=.:�;:� LEFT=-::- it; r:,
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CONTRACTOR:::: OWNER PHONE=
YR/MAKE=- }77 MODEL= LIBERTY
SERIALO= WIDTH= H= •t •4 LENGTH= 70 HEIGHT= 10
ITEM DEStF1'TlON QUANTITY #FAMOUNT
----------
INSPECTION FEE i 50.00
STATE SURCHARGEr" 4,50
COUNTY SURCHARGE t` 8,00
.1?• •Jr t?• tr :a: •i?• :,,: ar •/?..n: o+: * 9+::+?• 4c :++: * •n: * •n: •},i •'ti• )i• ii• i?• •H:• :+?• * :++: )e iH. PAYMENT ,`r . 1 t"1 ri •:; y X......),. *:u. *.fY n- K n: i?..)r it * •N: * •r• * K: r •n::::+?• r :.:n:
PAYMENT
..:r.t.11.. .t.iA.. ..: .. t••.E • : f4 PAYMENT AMOUNT
06/18/91 3869
'i'
TOTAL )t.0E:.
PERi1I_i. TYPE
---------------
MOBILE E'#(.1IiE PMT
62.50
..00 TOTAL PAID= 62,50
FEE AI1C)I..?NdT
C
62.50
i•'Rt3t.aF:.,`. ,'>t::.D BY: JULIE „EIA 1 t O
PRINTED B:i `T : JOHN E.. A R: I i N
AMOUNT PAID AMOUNT (OWING
62,50 .00
62,50 C:r.
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