1982, 08-18 Permit: 82A-7234 MHPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
f NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
N a!CA%8 JOC(- ?-0A� LEGAL DESCRIPTION -SEE ATTACHED
1.
2. '-H, I i
OWNER
3. --SC3f
ADDRESS
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CONTRACTOR
4. 010 A'C'" --
ADDRESS
DESIGNER
5. ADDRESS
SUBDIVISION PARCEL NUMBER/S />C��_Q��•
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CHANGE OF USE FROM ITO
6.
TYPE e"NEW
7, OF
WORK ❑ BLD.
DESCRIBE WORK
8. MO t -;
❑ ALT. ❑ AD'N. ❑ RPL.
ElIJ/ PLMB. ❑ MECH. M.H.
PHONE
ZIP
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PHONE
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ZIP
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PHONE
ZIP
❑ MVE.
❑ OTHER
❑ POOL
PERNWr NNUM&F_RR
i"�7 _ I
07* *10000
*100006
A *C00
Actual Set Backs in Feet // 7 2 3: 3;-:"
pp p
forth j South `.�� East Gl��.i West t� 0'8 1'8 �' 8 2
>ize of Parcel kv-Ze-,
one Classification
7' k MeLc Wmr 647c
Type Const.
Occupancy
Sprinklered
T
❑Yes ❑No ❑ Req'd.
/alyation
Building Area in Sq. Ft.
Main Floor Upper Floors
Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
I
I
Z
CERTIFICATE
Req'd.
Recd.
Not g�e'ea'd.
of EXEMPTION
I
✓'
Enum. Dist. Location (Area)
FEES COLLECTED
VALUATION I SOURCE GAS ELECTRIC I WATER SEWER USE CODE
Ownership
e�, UTILITIES OF CSC Public El Private Single $
1 hereby certify that I have read and examined this application and have read the '"NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS N m A, Plumbing
DATE OF APPLICATION i/j7 / Z�Y-F-SIGNATURE OF APPLICAN
SPECIAL APPROVALS SPECIAL CONDITIONS:
4(� LCX.tSILY A+ F9X-);-W93
ac 4mlz s ,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mech
Plan Check
SEPA
i
Mobile Home 1' O
Other (Specify)
TOTAL $ 1�P.4D
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
a _
Og'-g,T82. 723.42 *100.00aI-
DATE ISSUED PERMIT NO. TOTAL
r C
Manufactured Home:
Year 1982 Make GLENRIVER Width 28 Length 52
Vehicle Identification Number GR1986XY
Registered Owners:
NamjHOMAS E. & HELEN M. EADS Signatures'
Legal Owners:
Names CU FINANCIAL SERVICES Signatu
'SIGNATURES OF OWNERS INDICATE TERMINATION OF INTEREST IN THE MANUFACT
INDICATE INTENT TO PERFECT INTEREST IN THE MANUFACTURED HOME AS REAL
BEING AFFIXED.
ME THROUGH TITLEARdVIDED BY CHAPT 46.1'2 RCW AND
WITH THE LAND /SHE/THEY OWN AND TO WHICH IT IS/IS
Land to Which Manufactured Home is Being Affixed:
Property Tax Parcel Number 55082.1403
Legal Description Lot 3, Bk 1, Coach—Lite Estates, Vol 16, Page 1, Spokane Cou ty
Owners' Names Thomas E. & Helen M. Eads Signatures?
'SIGNATURES OF OWNERS INDICATE CONSENT TO HAVE THE MANUFACTURED HOME ADDED TO THE REAL PROPERTY LISTED ABOVE.
Building Permit Office Certification:
I certify that the manufactured home has been affixed to the real property as described above and/or building permit
number5NA — r7 a 34/has been issued for the purpose of affixing the manufactured home to the land and will be
inspected upon completion.
/30 Li _ 3 ;>
42.
NAME SIGNATURE BLDG. PERMIT OF CE DATE PHONE NUMBER
County Auditor/Agent Licensing Office Approval: (Not for use by subagents)
I certify that the above application appears to have been completed correctly, and that the applicant has sufficient
documentation to proceed with the recording of this form.
NAME SIGNATURE OFFICE/CAAP OPERATOR NUMBER DATE
Recording Office:
I certify that this form has been recorded in the county records.
NAME SIGNATURE COUNTY DATE RECORDING NUMBER
Note: Every person who falsifies or intentionally omits material information required in an affidavit is guilty of a gross
misdemeanor punishable in accordance with RCW 9A.20.021.
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