1991, 12-23 Permit: 91008765 MHSPOKANECOUNTY 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 provisions of any state or local law regulating construction, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF
OWNER OR AGENT
e- APPLICATION � `YY/
DATE
PROJECT NUMBER= 91008765
]ISSUED PERMIT DATE= 12/23/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 17021 E MEADOWBROOK LN PARCEL..x= 24541-9126
ADDRESS= GREENACRES WA 99016
PERMIT USE= DOUBLE WIDE MOBILE HOME
PLATY= MHO107 PLAT NAME= MEADOWBROOK VILLAGE
BLOCK= LOT= 2 ZONE= GA DIST4= F
AREA= F/A= A WIDTH= 92 DEPTH= 45 R/W= 40
4 OF BLDGS= 4 DWELLINGS= 1 WATER DIST = CONSOLIDATED IRRG 4i
OWNER= JEFFREY, PHYLLIS E PHONE= 509 922 4404
STREET= P 0 BOX 366
ADDRESS= GREENACRES WA 99016
CONTACT NAME= PHYLLIS JEFFREY PHONE NUMBER= 509 922 4404
BUILDING SETBACKS: FRONT= NA LEFT- NA RIGHT= NA REAR= NA
****************************** MOBILE HOME PERMIT **************************
CONTRACTOR= UNKNOWN PHONE=
STREET= UNKNOWN
ADDRESS= UNKNOWN WA UNKNOWN
YR/MAKE= 1992 RIDGEWOOD MODEL= LIBERTY
SERIAL= WIDTH= 28 LENGTH= 48 HEIGHT= 00
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 16.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE
12/23/91
TOTAL DUE=
RECEIPT4
96'23
.00 TOTAL PAID= 120.50
PAYMENT AMOUNT
120,50
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME PMT 1'=0,50
120.50
120.50 .00
120.50 .00
PROCESSED BY: WENDEL, GLORIA
PRINTEI? BY: WENDEL, GLORIA
******************************** THANK YOU *********************************