1990, 11-19 Permit App: 90006259 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. 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 T NI.,ji"{BF'F}= 90006 259
N:• :. :• • *• ii• •X..n i.: k. *• * ii' ii' ii• it iE �i• .) . (. 3.3 k• 3i ii * * is 3':
;I TE STREET=
ADDRESS=
PERMIT USE=
PLAT4=
BLOCK=
AREA=
OF BLDGS=
OWNER=
STREET=
ADDRESS=
..
c::oN.T.FirC..T. NAME=
BUILDING ;;'E T.t'fhl(..
DATE= 11/19/90
APPLICATION
A F P i„.1. C.: f -T T T U N .x..n ri• * i tii' i>• * ;p.:». K- N: ii it i( s?• ii :d.:rs 'ii fi: * h:' ar »
PARCEL:„::: 17543-0202
':' 1 1 N F.. A FR: R RD
SPOKANE WA 99206
DOUBLE WIDE: MOBILE HOME
/8 LOT= ZONE= SFR
00000000 ESA= A WIDTH=
&7 L-]3
a DWELL .:•....
ON ..JOHNSON
5004 N SIPPLE RD
SPOKANE WA 9921 2
JON JOHNSON PHONE NUMBER= 509
' FRONT= 40 LEFT= 46 RIGHT= 40 REAR=
PHONE= !:;09 926 457Fi
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DEF'i°•1_ T T•'1F: N i REVIEW COMMENTS APPROVAL COMMENTS
MEN
BUILDING SETBACK REVIEW I:E::ihl R7:..QI..j:lI:i..: ;
ENGINEER NF3y COUNTY 'r•` •••IAr) AFl::'F:. rA(i•i //a4Pc-./F'/V./4.3. -
HEAI...THt>:L .... idf'.. 1 '_,f, Di:l.T:iriAe"cd I`: WATER --&--4016�i......._.._.._../1.-../ .-: T.. -I.
PLANNING LAND USE ACTION..1•f..'':E te,+(Jl._'arl.-D zs
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;t•*•X�t**r.:�tri'*' : Vii-��:*x•ii•x•*3* ii..x.*. ;..x.*.:,>:* MOBILE TOME PERMIT � �' `S ,E 'x- •A' N' ;k 7>.' 3t' PF 9l• ik '1k !l,• 7!' il' ' C T: 'X' `fi::R i` •R` at ii"�%. "` '. i• •f:
it
CONTRACTOR= OWNER
R
YR/MAKE= 1925 f URDE:f MODEL=
PHONE=
SERIAL= WI.rPF•i:.:: 24 LENGTH= 60 HEIGHT= •i e;;j
ITEM D:; CR.r 'T.l:flN QUANTITY FEE AMOUNT
INSPECTION FEE E ... 'i00,00
STATE SURCHARGE 'r' 4,5(
COUNTY °i 1. RC HARG E. Y .1 :". ,, 4;J;'1
FEE AMOUNT AMOUNT i''F3'f) AMOUNT OWING;
120.‘50 ,00 12':;.50
FERMI T TYPE
MOBILE HOME F'M 7r
F' RO1:.:F:. >.SEI.) BY: : .iC FiN L..ARSON
PRINTED— BY : ..ifHN L_AR,'CIN
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SPOKANE t.:;OL y OfPARTMENT OF Zfv3.DINGS
130311FIOADWAY AVENut
3PC)K.02k Ng, WASUOTON 69280
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ft1! lIGNATURit OF
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'SPOKANE COUNTY HEALTH DISTRICT
ENVIRONMENTAL HEALTH DIVISION
FINAL INSPECTION FOR SEWAGE SYSTEM AT / J -57/
APPL.# �3�!
(numerical address or lot and block in plat or section, township, and range and road)
Please fill out in heavy dark line (felt-tip pen or equal) with a straight edge. P_an
is to include outline of structure (if available) as its position occurs on the prop-
erty. Identify by measurement actual location of septic tank, drainfield lines,
drywell, or other on-site sewage facilities, property lines closest to drainfield,
on-site well (when applicable), driveway, and road frontage. Septic tank ac ss
must be referenced .to a known fixed surface structure
PRO PtRTjr Liirc
FINAL INSPECTION MADE BY �c G,
COMMENTS (INSPECTOR'S NAME)
r -w 1'.^,.7�- ,
: r: .<77:w.AGE
Dr-'.AWINS
AN
L..AC L
1/81
(DATE)