1989, 04-18 Permit App: 89000885 MHSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. 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 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 APPLICATION
OWNER OR AGENT HATE
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,!"'-�::. Ii'.:P:'.. r•':K:='EINC,LE WI:LE It'±'Ti.! DOUBLE
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PLAY.!1. 000Y,2S PLAT NAME CAROLINE ADD,.
.:.: ±'v E I '•. HOWELL,
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:.;ONTAC NAME
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INFORMATION WORKSHEET
PARCEL NUMBER: 2353\ -‘4Z-7 S 11-1--D-
STREET
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STREET ADDRESS: Si 76 4/ enAINO ler
CITY/STATE/ZIP: S/4401- \Ir / (414_ 99c)/) ---
SUBDIVISION:
9c)/a"SUBDIVISION: 0/4.20 Li/c/C
4- .
BLOCK: C LOT: ZONE:ftlf 5 DISTRICT:
LOT AREA:
F/A: WIDTH: `t4 DEPTH: 2-7S R/W: ¢O
# OF BUILDINGS: $ OF DWELLINGS/:// //WATER DISTRICT: (4/?/c%#gc
OWNER: /UPC/¢ '•.-7,_'•.-7,_C�/LEL)EYz(J/) !�*rrtiCU-PHONE: 91107-53C- ?3.7 -c --
MAILING ADDRESS: --�yy.('_ AS 4Bpt-14
CITY/STATE/ZIP:
CONTACT: PHONE:
SETBACKS: - FRONT: «b LEFT2:' Ib' RIGHT: t44 REAR:
%NA
PERMIT USE: l AJ:5-5? LL O a u etc /1)1/ t 140,ettt
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: SEWER (Y/N):_ HYDRANT:
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Manufactured Home:
Year 1989 Make Chadwick Width
Vehicle Identification Number
IDFLK13A11699CW
28 Length 52
Registered Owners:
Names FRANCIS N. & NILA J. HOWELL Signatures'
Legal Owners:
FRANCIS
Names N. & NILA J. HOWELL Signatures' ./-
k 21. 7//S
'SIGNATURES OF OWNERS INDICATE TERMINATION OF INTEREST IN THE MANUFACTURED HOME TH OUGH TITLE PROVIDED BY CHAPTER 46.12 RCW AND
INDICATE INTENT TO PERFECT INTEREST IN THE MANUFACTURED HOME AS REAL PROPERTY WITH THE LAND HE/SHE/THEY OWN AND TO WHICH IT 15/15
BEING AFFIXED.
Land to Which Manufactured Home is Being Affixed:
35231.1474
Property Tax Parcel Number
N 1/2/of L. 9, Exc. N 10' & N 1/2 of S 1/2, Block 5, CAROLINA,
Legal Description Situate in Spokane County, Washington
'SIGNATURES OF OWNERS INDICATE CONSENT TO HAVE THE MANUFACTURED HOME ADDED TO THE ' EAL PROPERT LY IED ABOVE
Owners' Names FRANCIS N. & NILA J. HOWELSyignatures2X'
Building Permit Office Certification:
I certify that the manufactured home has been affixed to the real property"as described above and/or building permit
number 99 — ,Pf 6 has been issued for the purpose of affixing the manufactured home to the land and will be
inspected upon comw tion.
NAME
So -
SIGNATUR
SPOKANE COUNTY
BUI6.R1Abisi DISAFE1Y
%- Ry -97 YSG- 36JS
DATE
PHONE NUMBER
County Auditor/Agent Licensing Office Approval: (Not for use by subagents) .
I certify that the above application appears to have been completed correctly, and that the applicant has sufficient
documentation to proceed with the recording of this form.
NAME
SIGNATURE
OFFICEICAAP OPERATOR NUMBER
DATE
Recording Office:
I certify that this form has been recorded in the county records.
NAME
SIGNATURE COUNTY
DATE RECORDING NUMBER
Note: Every person who falsifies or intentionally omits material information required in an affidavit is guilty of a gross
misdemeanor punishable in accordance with RCW 9A.20.021.
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