1991, 09-25 Permit: 91006218 MHSPOKANE COUNTY DEPARTMENT 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 provisio of any state or local law reg ting construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION r. �>
OWNER OR AGENT /�� /!�/DATE
PROJECT NUMBER= 91006218
ISSUED rEriiDATE= }/-r/Sj PAGE= :
,
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SITE STREET= 006 tC:' i:{ 1;i)fIK 1...N 422 !..-f•!i'''(.,i:::i..":,,:::: 2454i-9126
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rl!7D{"•'.i::..'C'= ?i"'I..ri..fNE WA 99216
PERMIT USE= INSTALL DOUBLE i...E:: WisI?E: Mc)BIi...E i"i►:iME:
PLATO= M i..i t.; .j {.j 7 PLAT NAME= 111:. A ..` O W '.:' i' ° '.. ':` .: VILLAGE
BLOCK= LOT= 5 ZONE= UR -7 DISTO-
A R E r^l::::1 r`',:::: E- WIDTH= I) i-' i:;'1 1--i :::: 1;.: ;' L,; :::: i:;
:: OF1i...I/!yu ::: ') :n: DWELLINGS= .! WATER JJInS..{. .._
OialryF.:.R:.=
DUSi<'.0 , JO M
STREET= RE::E::T"::: '1 r?:i0c'; i::: r'ji::.r"YI;t:)hiI:tR(:)f.)it. LN 022
ADDRESS= DRi:::; S i::.!:ii:ANi::: WA 99216
PHONE= 509 226 1130
CONTACT •AM': . O w:DUSK _ PHONE 1i"Iii:509 .. . 1130
BUILDING SETBACKS: FRONT:
LEFT= •' RIGHT= T':::: REAR— 5
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CONTRACTOR= OWNER PHONE=
YR/MAKE= .j c/cr•i Pyr•"i, i••it.Jr"i 11t.iIiE.:.i...::::
S E:. I'L .i. A i... •,,..... WIDTH= :: � r:1 LENGTH- .ty •=`5 HEIGHT= 10
ITEM DESCRIPTION QUANTITY FEE AMOUNT
----------
INSPECTION T"isc:' FEE 2 i00...00
STATESURCHARGE T' 4.50
COUNTY i"Y URC1IAi":1 i..: Y 16,00
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PAYMENT rri'r; iiFT O PAYMENT ri(1NT
09/25/91 6926 120,50
................................................
J(.Ji:":::: :. !:t!:! TOTAL ! Yi... r A I it:::: 120,50
TOTAL t..
PERMIT T'Y'PE:: ;:i:E:: AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME F i'' ..i" 120„50 i :? 1"> :. '.'.i 4:) ,00
120,50 120„50 :. 00
. BY: : :..i(3Hi`y L.ARSON
PRINTED BY: JOHN LAR4'ON
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