1991, 05-07 Permit App: 91002373 MHSPOKANE COUNTY`TRIMATMENT 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 NUMBER= 91002373
APPLICATION DATE= 05/07/91
PAGE -
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:A E-
**Sixr THH:I:, 1S NOT l..i PERMIT *n :if:**
PENALTIES W:%i...{... BE: ASSESSED E'i:3r: COMMENCING WORK WITHOUT ', PERMIT
SITE STREET= r„4 N HOD
G_:E3 'ri(r{ .».. 17553-2404
AI1DR{:: S ':,: GREENACRES WA 99016
{=':RMl:.T USE= DOUBLE WIDE:: M(:i1C{:t:I... HOME— REPLACEMENT
PLAT
T,:= 00.1407 I::•I._r::,'E' NAME= ....F3BE::f;F;Y Mi:lB`ii..L PARK A.i..?
BLOCK, LOT= <:. i. r c,{ i":::: UR -7 I - ';' 4 ::.:
AREA= 00007800 F/A= F WIDTH= 65 DEPTH= 120
DE BLDGS= DWELLINGS= 1 WATER DIST
OWNER= i Ei W(:iiRT H , RALPH
STREET= 50.4 N H(l:DG ,' RD
ADDRESS= GREFNACRES WA 99016
PH; -,NF,,
CONTACT Ni,(_ij • SHELLEY i E:rfl4or;,.{.H-•7 PHONE NUMBER= 709 924
BUILDING SETBACKS. FRONT= t::: x::{: ,`.:" LEFT= E_ ..:i: `; RIGHT= EXIS REAR= i::: X I S
it •ii• r: •: •b:• * i;: * # : 5i- ?i• h•. . •h; h:• * :d• : * n; ii * -ii• •ii• i!• * ;i- •ii REVIEW T N {:. O F M A r :f. (:i i'J :+e •Si 7k -r• �£ r: h::�i..:: r ii ri• »: it • �i• r:• i;• • :�• :�i n• ��:: � !
DEi'ARIMEN1.
BUILDING
REVIEW COMMENTS APPROVAL COMMENTS
SETBACK REVE.EW REQUIRED
H E: A {.....i. !-'{ T:` I:: ° Y• INCREASE IN 1.. Ol .I. COVERAGE
a^ ai,• * •ii * -ji yi. * * ?i- * ii• n. i{• y,- :»: i i ti• ,i• ii ii * * ,* ..:r..ii. y,, tom! (1 J:, :f. i... E:: HOME R F { M I: :h is �i =63: ij 3 i )i ii i+; }i• •iF ai },; •j� ii :rt 3i ) ..h :,i: y, .,r ri ::.
CONTRACTOR= OWNER
.
987 MODEL= _EETWOOD
SERIAL":::: WIDTH= ,-< L.EENi:;TFiLL: 48 HEIGHT=
rEi f{T =
10
ITEM DESCRIPTION QUANTITY -: AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE 4.50
COUNTY SURCHARGE t' 16n00
l:::.E. AMOUNT AMOUNT i='!}:i::(' AMOUNT OWING
G
PERMIT TYPE
MOBILE HOME PMT
120,50 120,50
120,50 ,00 120,50
:: E,D BY IE.11...:1.Er.: .'i•fr=tTT (
E' R I: 9 T• E D Fi :(, : ,.J I I L..1: E:: "• i -i A T T• r:;
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