1989, 03-17 Permit App: 89000508 MHU
ICL
1=thuU
SPOKANI COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON ono
(30) 4841-3M
i certify that hay. examined til o Canna and state that the Information oontalned n It and submitted by me or my agent to compile sal d perm it Is two and correct. In
addition, I have mad and understand the fl48PEOTION 1,11OUIREMENTB/NOTIOt provlelone included here!ri and agree to oomply with earns All provision, Of laws
end Ordinances governing this type of work will be compiled with whether tinseled herein or no1. i understand that this issuance of this permit and arty subsequent
insoiletion approvals or Cartifiostae of Ctocuponoy shall not be oortoleued to give authority to violate or cancel the proviolons of Offy slate Or local law reoulalino
construction, or 10 I warranty of conformism°, with the proyillOns of any etre or 10041 !IWO reoullitin0 Construction,
gICINATUREI OF
OWNER OA AGENTAPFLICATjON
PkOJEcT NO(1BER 6900050v3
VATC ()/17/a9 PA(;Et, 01
APPLICATION
mg**440(0x*Kg4(0(q4)(q:v APPLICATION *)f*A:VNg4/tP-Of*.4**40H4
&TTE STNEET,,:, 1B316 E LIBERTY AVE
ADDNEnr- SPOKANE WA 99216 045N4-1007
PERMIT ua REPLACE MOBILE Homr
PLATI
BLOCKu
AREAk
4 OF FILDGS:
00046 PLAT NAMEt,, DONWOOD EAST
LOTL, 7 7.0NE r'Cf1H
00000000 r./A P WIDr-
1 4 DWELLINC. 10
OWNERm VINGO, i C
STRECTu ie316 r LIPERTY AVE
ADDRUSv, YPOKANE WA 9ni6
CONTACT NAME,;: DAVID DAXTER
DUILD1NG STTBAOKS: PONT= NA LEFT" NA RIGHTn NA REAR Ni
PHONE NUMDER" .709
""*""*"*""4"x*".04gk MODILF: HOME PERMIT /(*04*11:4*Oitt**14-k444**);
CON1kACIOR OWNER
PHONE
P HO
I'd
5937
YR/MAKEg:t 1976 SKYLINE MODEL
SERIALO 200K WIDTH14 LENGTH" 70 HFIGHT 10
ITEM DESCRIPTION OUANTITY FEE AMOUNT
INSPECTION FEE
ROXLDXNG SURCHARGE 1 50,00
3,50
04v#:)0t**xm44,0*.NN*4000*4)0**01 PAYMENT SUMMARY **"""
PAYMENT DATE RECUTPTO PAYMENT AMOUNT
-• IAN pr. 1.16
WS/17/89 4;3
TOTAL "PUE. .00 TOTAL PAID 53.50
PERMIT TYPE rrr AMOUNT AMOUNT PAID
MUbILE HOME PMT
PROCU;SED BY; STEVE HOLYK
PRINTED BY: STEVE HOUK
(r/fkKticA7,00.;k**Nk******gVO
AMOUNT OWING
.00
,00
(1(
THANK you 414(16.X.4040:*
+044I1*4 *It100**4*
INFORMATION WORKSHEET
PARCEL NUMBER: &0 /4-1:g4/ 1 9 /<
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
BLOCK: 7 LOT:
ZONE:
LOT AREA:/F/A: WIDTH:
DISTRICT:
‘1414-
: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: PHONE:
MAILING ADDRESS: No 7j
CITY/STATE/ZIP:
P /_�M , 9 C)c./17
PHONE: \-0-9 -Isa - 0 ! j 7
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
****************************************************************************
BUILDING INFORMATION
CONTACT: A(
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
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: