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1990, 06-08 Permit App: 90002617 MHSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY W. 1303 GROADWAYAVENUE SPOKANE, WASHINGTON 9926U (509) 456-3675 / certify that / have examined this o°m/vx*/0000,state that the information contained m/,and submitted brmoonn»agent mcompile said permit/application true and correct, and authorize Spokane County 1 have read and understand*e/wSpsor/umnsumncwcwrS/wnr/uc 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 AppuC*T|8w OWNER OR AGENT DATE PK0JECT HUMBER. 900A2617 DATE= 06/88/98 PAGE= 81 APPiMAT{;N ********fl******************4)t APPLICATION **************»*****************» SITE STREET= 18721 F MARLIN DR PARC[l'4= 08552-0313 ADDRESS= OTIJ ORCHARDS WA 99027 PERMl[ USE= DOUBLE WIDr MOBILE HOME - R[P/.ACEMFNT � Or PAT4- HLDCK= AREA= HL0GS= OWNER= STREET= ADDRESS= 888145 PLAT NAME= PARKER RV�D M0B[LE HOMER 2 LOT= 13 ZONE= KMH VIJT4:- 1: F/A= F WIDTH= 94 DEPTH= 4 DWELLINGS= i HAYGARD/ CHARLES & LEITA 1 RHONE= 509 924 1521 10721 E MARLIN DR OTI% ORCHARDS WA 94827 CONTACT NAME= CHARLES HAYWARD PHONE BUILDING SETBACKS: FRONT= EXIJ LEFT= FUS RIGHT= ExIJ *********k********»**»******** REV[EW INFORMATION DEPAR7MENT ---------- PEVIEU COMMENTS HEALTHDI%T NEW OR ADDITIONAL WASTE WATER PERMIT ******************************' MOBILE HOME Po`nlT NUMBER= '509 924 1523 REAR= UIS x**x******x»»**********0»x APPROVAL COMMENTS / % �~=t=u',^�����./ / ' ` r7� evrvp*ttvv�� /�/ eX/�fi��v/^~ *********�'*�xx**�• • it ' CONTRACTOR= OWNER PHONE= YR/MAKE= 1998 MARLETTE MODEL= S[RIAL4= WIDTH= 28 LENGTH= 48 HEIGHT= i8 PROCESSED BY: WEND[|'/ GLORIA PRINTED HY: WENDEL/ GLORIA ******v**************x*xxx****** THANK YOU ********************************* Spokane County DEPARTMENtOF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: Cl 8'5$oL — 03 /3 STREET ADDRESS: Gi87a( Anat., , I CITY/STATE/ZIP: dd a1ah-te ! h% . l45 SUBDIVISION: BLOCK: .2 LOT: /3 ZONE: DISTRICT: ' LOT AREA: F/A: WIDTH: CITY 1 DEPTH: /35 R/W: (,O # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: CA(/LA'S ) • „Weir U/ - trAPHONE: ✓r0% -- MAILING ADDRESS: /Pp. 26)1, 33? CITY/STATE/ZIP: -Acete4Ad . �CL. 9';20/4" 0 338' CONTACT: SETBACKS: — FRONT:.X/S LEFT: PERMIT USE: DCUBLt tot t)E PHONE: RIGHT: 1j'/S REAR: 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: RETURN ADDRESS or WASHING TON MANUFACTURED HOME PLEASE CHECK ONE L4lSTATI' ,=,Imm1°'. itEnsifC APPLICATION ❑TITLE ELIMINATION Jr TRANSFER IN LOCATION Anyone who knowingly makes a false statement of a material fact Is guilty ©REMOVAL FROM REAL PROPERTY of a felony, and upon conviction may be punished by a fine, imprisonment, or both. (RCW 46.12.210) a MANUFACTURED HOME TPO / PLATE NUMBER YEAR 1990 MAKE Marlette LENGTH/WIDTH(FEET) 28 X 48 VEHICLE IDENTIFICATION NUMBER WIN) H-004913AB i fl LAND LEGAL DESCRIPTION ON PAGE MANUFACTURED HOME WILL BE a AFFIXED ID REMOVED REAL PROPERTY TAX PARCEL NUMBER 55082.0313 LOT BLOCK PLAT NAME OR SECTION/TOWNSHIP/RANGE OUARTERIOUARTER SECTION 01 GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS NAME OF REGISTERED OWNER 001 CUSTOMER ACCOUNT NUMBER Dennis E. Reger NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE GRANTEE NAME I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT 11 WE AM/ARE THE REGISTERED OWNER(S) OF THIS VEHICLE AND THIS INFORMATION IS ACCURATE: Signature of Registered Owner and Title, IF APPLICABLE Signature of Additional Registered Owner and Title, IF APPLICABLE NOTARY SEAL OR STAMP NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S) SIGNATURE State of Washington Signed or attested County of before me on by Signature PRINT NAME OF REGISTERED OWNER NOTARY OR AGENT by PRINT NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY County/Office No OR Title AND: Dealer No. OR DEALERSHIP POSITION/AGENT/NOTARY Notary Expiration Date a TITLE COMPANY CERTIFICATION I certify that the legal description of the land and ownership is true and correct per the real property records. NAME (TYPED OR PRINTED) TITLE COMPANY I PHONE NUMBER I SIGNATURE / POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. 0 BUILDING PERMITJOFFICE CERTIFICATION Wthe Certify that: the manufactured home has been affixed to the real property as described. D a building permit has been issued for this purpose and the attachment will be inspected upon completion. NAME(TYPEDICE -E )U�A( BLDGPERptIT T 1 S(i OFFICFJPMO. M003S 8SSFENAus (�pG PERMIT `j ��u I^ SIGNAT OSITIO aGe *r T co (qATE to / O(r) 8