1987, 06-05 Permit App: 87001650 MHd
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
NORTH 811 JEFFERSON
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. 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 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= 37001650
DATE= 06/05/87 PAGE= ! i
***********:******:*4************** APPLICATION 43• 9Rpp)P` *# # :gF j * tindfijd K ndk (
SITE STREET= 2714 ItSrt(N MICA Frr,r(:Ir-29544-9009
ADDRESS= SPOKANE IATA 99206
PE::IRS:M:l:r USE::-: DOUBi..I..: WIDE. MC)}:fIL_E I•ir)tlE:
PLATO= 003203 1• -'I. -AT NAME= SP -421 '-c-'Q-� .
BLOCK= LOT= 4 ZONE= AGRI 1)l:E..I..n_ E:
AREA= 000()0O01 1= /A::: A WIDTH= 242 DEPTH= I-1:= :: r 2 k W =
OF 8L..r;rgS:_: 1 ro: DWELLINGS= 1
OWNER= HAUENSTEIN, KENNETH I._
STREET RT, 1, BOX. 75
ADDRESS= 1 SS 1iAL..l..l.":Yi c)kl} WA 99036
CONTACT NAME::-:: r)WNEl:
PHONE= 509 448 4307
PHONE NUMBER= 509-922-3400
Bi_):LLr}:r.N(, SETBACKS: FE't(:)NT:.: 152 I...EF.T 138 RIGHT= 108 REAR= :::: 5i
**.p,... 3. 3. *..Ir..p...*. 3..3.. • 3*. 3, .* .* .* * 3*.......M....M..ft• 3* * * 3*
DEPARTMENT NAME
(::OJNTY I:::P:il:':I:NI:::I:::
REVIEW INFORMATION
REVIEW COMMENTS
NEW COUNT' ROAD APP9O' A•4j.j.zi _) 070605
:>
DATE
:EN/OUT :[Ni: rIAL S
1=NvIRONME:NTAL_ HEALTH
NEW OR Anil 4 A ;i• r I::: WATER
C: t 060!:.
-*****4************************ MOBILE HOME IRM . 1- * -it iE : r i!- * * * ?i :rt *:¢ k• * ii : * :ii • :tt- a: -r: *'b:
CONTRACTOR= = OWNE::R
YR/MAKE= 1987 FLEETWOOD I :E.TWtOOD MODEL.:=
" =:TAL;_WIDTH=
26 L.. E::NCY'T'h•i=:: 48 HEIGHT= 10
ITEM DESCRIPTION QUANTITY FEE AMC)UNT
INSPECTION FEE 2 100.00
I:tL.)I1..I}INc; SURCHARGE v 1,50
0
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME PMT 101.50 .00 101.50
101.50 ,00 101.50
PROCESSED BY: WiE::Nr}E:L, GLORIA
p(fia*Uttiyhpy*pb*pttIb1yp**p*jpyuTHANK Y .. **************************§§*****
(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPART
' Project Number
Owner's Name LAST FIRST MI
Project Address (St eet Name & Number) Zip
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State
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Contact
License Number (Required)
Business Phone
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Architect/Engineer
Address
City
State
Zip
Phone
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Contact
Business Phone
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Lender
Address
City
State
I Zip —1 Phone
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