1992, 04-28 Permit App: 92002900 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 I t and submstied by me or my agent tocompilesaid 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 specdied
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, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
• PROJECT NUMBER=== 9200290*) APPLICATION DATE= 04/28/92 PAGE= 01
•
A•A•3F#AA THIS IS NOT A PERMIT .>i.A..*AA..h.
PENALTIES WIL..L. BE. ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE ,STREET=.
ADDRESS=:
PERMIT USE=.
PL.AT4=•:
BLOCK=
AREA=
OF BLOCS=
OWNER=
STREET=
ADDRESS=
1210 S DISHMAN RD
SPOKANE WA 99206
TRIPLE WIDE MOBILE HOME — REPLACEMENT
002378 PLAT NAME= SIESTA MOBILE PARK ADD'
6 LO1= 2 ZONE= UR -3 D.L'H=
F"/A= F WIDTH== 75 DEPTH= 110
1 DWELLINGS= 1 WATER DIST
PARCEL -0== 20543-0903
JOHNSON, ERIC & YVONNE.
1210 S DISHMAN RD
SPOKANE WA 99206
CONTACT NAME= THRIFTY MOBILE — DAVE
BUILDING SETBACKS: FRONT- 27 I...EFT_: 5
****A•3i3FA•#tikiiiFi+.Aai******A:•#AA•A•A•ir A• REVIEW INFORMATION A:A•tP****************•#A•A•****
PHONE= 509 927 0131
R/W=
PHONE NUME+F.:R==.' 509 535 8881
RIGHT= 14 REAR= 3+
DEPARTMENT
BUILDING
HEfd..THDIST
REVIEW LOMME.NTS
SETBACK REVIEW REQUIRED
NEW OR ADDITIONAL WASTE WATER
*3 3*3*+#3E34*A*A+** 3FA3f3it A*+A•#A+*#3*A*A*3e#
APPROVAL COMMENTS
MOBILE HOME PERMIT ***********************r***
CONTRACTOR= UNKNOWN
STREET= UNKNOWN
ADDRESS= UNKNOWN WA UNKNOWN
1992 BROOKSHIRE MODEL=
WIDTH=
YR/MAKE::
SERIAL4=
ITEM DESCRIPTION
INSPECTION FEE
STATE SURCHARGE
COUNTY SURCHARGE
PERMIT TYPE
MOBILE HOME PMT
FEE AMOUNT
181,50
181 :.56
PHONE=
41 LENGTH==
QUANTITY
Y
AMOUNT PAID
00
,00
PROCESSED BY: WENDEL, GLORIA
PRINTED .BY: WENDEL, GLORIA
**3en:**3(**A***1+**#*****3r*k3i****•*3&* THANK
A
56 HEIGHT= 00
FEE AMOUNT
----------
150A00 50A00
4.510
27,00
AMOUNT OWING
181.50
181,50
YOU 3Ftt'3i3i•34:rt'#'z A'#3t 3F r. A3iA A•#A Aar. v:
*3f3f 3k A*A* 341e 3E
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
'15103 .0q03
()110 s_ D tb �w.c-y
Spa irate (A
Sees y ttoloie
L) -ab 37
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA:
PARCEL NUMBER:
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
hart( rSida hbi P�.vk L /
F/A: WIDTH: 75E DEPTH: (10 R/W:
# OF BUILDINGS: # OF DWELLINGS: l WATER DISTRICT: 4,4$br W€5 r 3
OWNER: f y c Jo{'w"
sa. PHONE: - -
MAILING ADDRESS: q/I�bOL/e_
CITY/STATE/ZIP:
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: TIng M lob -(e HDtas
MAILING ADDRESS:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE:
F� go?AS praj Lt e
S3S - $ C5 )
PHONE:
NEW: REMODEL:
ADDITION:
DWELL UNITS: OCCUPANT LOAD:
BUILDING DIMENSIONS:
REQUIRED PARKING:
Li
CHANGE OF USE:
BUILDING HGT:
STORIES:
(WIDTH X DEPTH) SQ. FT.:
# HANDICAP: SPRINKLERED:
CRITICAL MATERIAL:
70'
S. \2\0 L7i.\,,,o,
Rd
v -c e` `l5 2 03 DQ 03
JO'
27
75
Q�
r