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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** a) 7 n N . 0 s 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 gM(1G. 13 RGJo moi'?G-6 gVr, OWNER or OCCUPANT - // //Phone 1 FiS a 3 5 'YYI /4 R L f i 0 As o g c. 6 (?d// 9 1bS X1 992)S-7 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. l'abusA4/Oe.41€ 7na o ADDR-'' &ON COAD WIDTH%UMMBNTS (> RRONT L/(n FLANK gAtIFWED By i to IA tu 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 .....�����.....yyyyy '' -/ e 7 _j-- a... ....:-/ - ' 7cte.. exx\. L.lJTCI14WJ % MP. Ntifi./y/ .'•• llpZ'• .4a-,-� Di' �; 7a :ti; -:E V O = .3- ‘70 ,' f " / A,� 9/ssIWW0.�..- �1..$' 1'V� '^''^ 03.3 r/ Sr 1S \\ ///na ///� ��)\\\\\\ 111 fltil State by by Title NOTARIZATION/CERTIFICATI' of Washington County of 1% Aly J• ' FOR - EGISTERED ,5 ///��,,� dart Signed or attested �befgre atur OWNER(S) SIGNATURE D� a me on 5 vt—ok "Irta DREDOWN Mt SI OWNER bruits Pt JSQ&Z �� PRINT NAM OF REGI FRED pop I htnc NOT leIn—�4 NAME OF County/Office AND: Notary OR ACEI G ✓ 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 ,d}!(�1- ( ISt BLDG 95 1009(0;20 09 L0 2 0(� --5— IiyW8 -0 .BLDG '�5-061.624e 1 G�"+41 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�. ,01141MilitAwAmp J\\\ 011/4 ,..... v. G�4 N .'• l%pr'* 9 w; - kim' t a0 R:�a—. : Q :n' �%b 0- = P P. JON rco, - ' P/rf(w�0,p••.r•-- \ ,(�/''Yr , ...} `\\\\\\\` 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 ^^'t'/' 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). g 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