1991, 06-04 Permit App: 91003064 MHt �. h
SPOKANE 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 10 violate or cancel the provisions of any state or local law regulating construction. oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 91003064 APPLICATION DATE= 06/04/91 PAGE= 01
****** THIS IS NOT A PERMIT *****•*
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 1409 N GRADY RD PARCEL.O= 17552-0507
ADDRESS= GREENACRES WA 99016
PERMIT USE= REPLACEMENT OF SINGLE WIDE MOBILE HOME
PLATO= 003502 PLAT NAME= MISSION VISTA
BLOCK= i LOT= 7 ZONE= UR -7 DIST;= G
AREA= 00000000 F/A= F WIDTH= 78 DEPTH= 156 R/W= 50
O OF BLDGS= 1 O DWELLINGS= i WATER DIST =
OWNER= PORTER, CLARK PHONE= 509 926 5111
STREET= 11920 E MANSFIELD AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME.::= CLARK PORTER PHONE NUMBER= 509 926 5111
BUILDING SETBACKS: FRONT= 40 LEFT= 39 RIGHT= 25 REAR= 46
***•***•*•*•*;c.*****fl**4•****3E***** REVIEW INFORMATION **fe#***•***fi*******•********
DEPARTMENT REVIEW COMMENTS APPROVAL COMMENTS
BUILDING SETBACK REVIEW REQUIRED
HEALTHDIST NEW OR ADDITIONAL. WASTE WATER
******.l************fi**fF******** MOBILE HOME
CONTRACTOR= OWNER
YR/MAKE= 1974 BUDDY
SERIALO=
do -CaEk -_j,R. £(/0V01.N-Ce-
__
PERMIT***•**•*****************.*..*.X3e
PHONE=
MODEL=
WIDTH= 14 LENGTH= 70 HEIGHT= 10
ITEM DESCRIPTION QUANTITY FEE AMOUNT
INSPECTION FEE i 50.00
STATE SURCHARGE Y 4,50
COUNTY SURCHARGE Y 8.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME PMT 62.50 .00 62.,50
62.50 ♦00 62+550
PROCESSED BY: JOHN LARSON
PRINTED BY: JOHN LARSON
******************************** THANK YOU ***
***********************7***_
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: Al lyd9' Grac/y Revd
CITY/STATE/ZIP: sopQkan / a4d/, r4n, 790/6
SUBDIVISION:
BLOCK: LOT:
ZONE: DISTRICT:
78 /56,
LOT AREA: F/A: WIDTH: Mr DEPTH: `4p/'R/W:
# OF BUILDINGS:
OWNER:
MAILING ADDRESS: Ei // 920 )4'Zan s f',e1c/ A7` y8
# OF DWELLINGS:
WATER DISTRICT:
PHONE: .57,9 - 9,26- 5!/
CITY/STATE/ZIP: 4c t , Washto4100 , gq?o6
CONTACT: Clark Porte.t,- PHONE: SO? -926 - S///
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: / r / x 7D / Buddy P974/
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
BUILDING INFORMATION
PHONE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS:
X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
•
•� 74
/ O
1:
aj
i
41,
GRADy'4'o/
- /2 &'- O!!i
t
4
yE.
.-1
• H