1995, 06-26 Permit App: 95004620 MHPROJECT NUMBER= 95004620
APPLICATION'
DATE= 06/26/95 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 18823 E MARLIN DR
ADDRESS= GREENACRES WA 99027
PERMIT USE= MANUFACTURED HOME
PLAT#= 000145 PLAT NAME=
BLOCK= 2 LOT=
AREA= 00000000 F/A=
# OF BLDGS= 2 # DWELLINGS=
OWNER= BRECTO, EARL
STREET= 18823 E MARLIN DR
ADDRESS= GREENACRES WA 99027
PARCEL#= 55082.0309
BARKER ROAD MOBILE HOMES ADD.
9 ZONE= UR -7 DIST#= G
F WIDTH= 125 DEPTH= 75 R/W= 60
1 WATER DIST =
CONTACT NAME= EARL BRECTO
BUILDING SETBACKS: FRONT= 46 LEFT= 50
PHONE= 509 926 6646
PHONE NUMBER= 509 926 6646
RIGHT= 37 REAR= 15
****************************** REVIEW INFORMATION *****************************
DEPARTMENT
BUILDING
COMMENTS:
REVIEW REQUIREMENT
SETBACK REVIEW REQUIRED
HEALTHDIST INCREASE IN LOT COVERAGE
COMMENTS:
CONTRACTOR= OWNER
YR/MAKE= 1995
SERIAL#=
ITEM DESCRIPTION
CA2 /00
64/9
MOBILE HOME PERMIT *****************************
PHONE=
MODEL= NASHUA
WIDTH= 24 LENGTH= 42 HEIGHT= 12
INSPECTION FEE
STATE SURCHARGE
COUNTY SURCHARGE
PERMIT TYPE FEE AMOUNT
MANUFACTURED HM
122.50
122.50
PROCESSED BY: DAWN DOMPIER
PRINTED BY: DAWN DOMPIER
QUANTITY FEE AMOUNT
2
Y
Y
100.00
4.50
18.00
AMOUNT PAID AMOUNT OWING
.00 122.50
.00 122.50
PROJECT NUMBER= 95004620 APPLICATION
DATE= 06/26/95 PAGE= 02
:www*** «******+mow« ************ THANK YOU *****************************w*:mow**
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APPLICATION INFORMATION ,5.5 6 $2 .0E05'
%What is the .106 SITE address? ASSESSOR'S tax parcel number? �''�
O5 ,`'Z1(ai2a
Legal description as it appears on the property deed
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OWNER or OCCUPANT - // //Phone
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Mailing address City, state Zip
Who should we contact regarding this project? Phone
What work is being done under this permit?
Zone . ... ... : . . . -.
Inspector, district-, ..--.-:- - :
roperty size - :., •.. :....
Right of way width
Water district
Building
Building height
# of stories
Contractor
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd floor area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
Whet is the heat source?
What is the coat of your project?
Manufactured Home
Sign
Width:
n LI /
Length:
Lid/ -
What is the square footage of
the sign face?
How high is the sign?
Year:
199.-
Make:
-.2Itil 54 u l9
.
Installer -
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address -
Mailing address
Relocation
Fire Safety
Previous address -
Fire Sprinkler Tent
_
Paint booth _ Fire Alarm _ Fireworks display
VALUE -
Contractor
Contractor
WA State Contractor license #
WA State Contractor license # '
Mailing address
Mailing address
(Fuel Storane Tanks
Swimming.P,00i.
(Circle one) Above -ground Underground
Size / gallons
Private
Contents of tank(s)
-
Size / gallons. .
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
WA State Contractor license # •
Mailing address
Mailing address
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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ADDR-''
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RETURN ADDRESS
GUSTAFSON & HOGAN, P.S.
1500 WEST 4TH AVENUE, SUITE 408
SPOKANE, WA 99201
CILWASHINGTON nut DEPARTMENT OF Manufactured Home
LICENSING Application
Anyone who knowingly makes a false statement of a material fact is guilty
of a felony, and upon conviction may be punished by a fine, imprisonment,
�y
DOTITLE
TRANSFER
REMOVAL
(RCW
`PLEASE'CHECKONE
ELIMINATION
IN LOCATION
FROM REAL PROPERTY
46.12.210)
■
•
or both.
-j, MANUFACTURED HOME
TRO / PLATE NUMBER
+086734
YEAR
1996
MAKE
NASH
LENGTWWIDTH(FEET)
42 X 24
VEHICLE IDENTIFICATION NUMBER(VIN)
NN1D35012AB
2 LAND LEGAL DESCRIPTION ON PAGE
MANUFACTURED HOME WILL BE ['AFFIXED
REAL PROPERTY TAX PARCEL NUMBER
55082.0309
• REMOVED
LOT
9
BLOCK
2
PLAT NAME OR SECTION/TOWNSHIP/RANGE
08/25/45
OUARTER/OUARTER SECTION
NW
!$i GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE
COUNTY NUMBER
32
NUMBER OF REGISTERED OWNERS
1
NUMBER OF LEGAL OWNERS
1
NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
Betty J. Brecto
NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
18823 E. Marlin Dr. Otis Orchards WA 99027-9560
NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
Betty .1. Brecto
NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
18823 E. Marlin Dr. Otis Orchards WA 99027-9560
GRANTEE
NAME
Betty J. Brecto by: Douglas Gene Brecto (PR)
I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY
VEHICLE AND THIS INFORMATION IS ACCURATE:
Signature of Registered Owner and Title, IF APPLICABLE
SiD tioliet/{if itional Registered Owner and Title, IF APPLICABLE
THAT I / WE AM/ARE THE REGISTERED OWNER(S) OF THIS
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State
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Title
NOTARIZATION/CERTIFICATI'
of Washington
County of
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' FOR - EGISTERED
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Signed or attested
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atur
OWNER(S) SIGNATURE
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PRINT NAM OF REGI FRED
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NOT
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NAME OF
County/Office
AND:
Notary
OR ACEI
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NOTARY
No OR J /
Dealer No OR '( �
NTOF REGISTERED OWNER PRINTED
/�% L y(/
/ H'r t y
DEALERSHIP POSITION/AGENT/NOTARY
S
ExpiraLon Date
101 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 / PHONE NUMBER
Gustafson & Hogan, P.S. 509-456-0400
SIGNATURE / POSITION DATE
Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs.
$I BUILDING PERMITjOFFICE CERTIFICATION
1 Certify that: Ce the manufactured home has been affixed to the real property as described.
0 a building permit has been issued for this purpose and the attachment will be inspected upon completion
NAME (TIP OR PRIME
/
MIT (o �E/PH 23rE 6
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BLDG 95 1009(0;20
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SIGIrNNA/.T11URE/PNNIIOBiTT L.W� A-(J_„(I/C��
TD -420-729 (R/6/06) W Page 1 of 2
MANUFACTURED HOME - FROM SECTION 1
TPO/ PLATE NUMBER
+086734
YEAR
1996
MAKE
NASH
LENGTH/WIDTH(FEET)
42 X 24
VEHICLE IDENTIFICATION NUMBER )VIN)
NNID35012AB
6
SIGNATURE OF LEGAL OWNER
SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMINATION OF TITLE / REMOVAL FROM REAL PROPERTY.
Signature of Legal Owner and Title, IF APPLICABLE VJS Otbr
Signature of Additional Legal Owner and Title, IF APPLICABLE • a' h�.
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NOTARIZATI N/CERTIFICATION FOR LEGAL OWNER(S) SIGNATURE
State of Washington / � Signed or attested 5_//1 2A9(
County of PUKi./K bet re me on "�'1'/w
T &tai's SI nature I
by g
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PRINT NA E OF LEGAL OWNER NOTARY OR AGENT
by 22 Uo MJ eadreat,PA... 1I1(a J(anfaaV€✓
PRINT NAMELLLEEGG/pL OWNER PRINTED NAME OF NOTARY
ARR No OR
County/Office
AND: Dealer No. OR U nu!
TitleDEAAiaSHIP
POSITION/AGENT/NOTARY Notary Expiration Date
7
LANDVDIEE`SCR7I`PTION (A legal description of the land can be obtained from the local County Assessor's Office)
LOT 9, BLOCK 2, BARKER ROAD MOBILE HOMES, AS PER PLAT RECORDED IN VOLUME 9 OF
PLATS, PAGE 48, RECORDS OF SPOKANE COUNTY; INCLUDING THE MOBILE HOME LOCATED
THEREON;
SITUATE IN THE CITY OF SPOKANE VALLEY, COUNTY OF SPOKANE, STATE OF WASHINGTON.
a DEALER'S REPORT OF SALE
I CERTIFY THAT THIS INFORMATION IS CORRECT. THE VEHICLE IS CLEAR OF ENCUMBRANCES EXCEPT AS SHOWN.
ANY REQUIRED SALES TAX HAS BEEN COLLECTED.
DEALER NAME (TYPED OR PRINTED)
WA DEALER NUMBER
DATE OF SALE
PURCHASE PRICE
TAX JURISDICTION/TAX RATE
DEALERS AUTHORIZED SIGNATURE
U USE TAX EXEMPT Sale to a Certified Tribal member on the reservation (attach notarized statement of delivery).
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COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL: (Not for use by Subagents)
I certify that the above application appears to have been completed correctly, and the applicant has sufficient documentation to proceed
with the recording of this form
NAME (TYPED OR PRINTED)
COUNTY OFFIGENFS OPERATOR NUMBER
SIGNATURE
DATE
rrl TITLE FEES
FILING FEE
APPLICATION
MOBILE HOME FEE
ELIMINATION FEE
USE TAX
SUBAGENT FEES
MPORTANT: Once the application has been approved by the County Author / Vehicle
TOTAL FEES & TAX
Licensing Office, take your application form to the County Recording Office.
Retain proof of the recording fees paid. If the Recording Office retains
your original application form, obtain a certified copy of the recorded form.
APPLICANTS: Once recorded, you must return to a Vehicle Licensing office to file the
Manufactured Home Application, paying all required fees. Vehicle
licensing subagents charge a service fee.
For full instructions on completing this form for Title Elimination, Removal from Real Property or
Transfer in Location, see form TD -420-730, Manufactured Horne Application Instructions.
The Department o/ Licensing has a policy of providing equal access to its services
If you need special accommodation, please cal (360) 902-3600 or TTY (360) 664-8885
TO -420-929 (R/6106) W Page 2 of 2