1987, 09-08 Permit App: 87002927 MH S ..y,§
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
NORTH 811 JEFFERSON
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 DATE
PROJECT NUMBER= 137002927 DATE:- 09/08/8 7 PAGE= 01
iii***********it**ii************** * APPLICATION x*•x*•**** *******x**tttt******
SITE STREET= 19422 E SPRAGUE AVE PARCELO::= 20554-0159
ADDRESS-: SPOKANE" WA 99016
-= REPLACE SINGLE WIDE W/DOUBLE WIDE MOBILE. HOME ( T.�(�RM� j
PERMIT USI 2i/x c0/'6
PLATO= 000498 FLAT NAME= CORBIN ADD TO CYREE::NACRE:S
BLOCK== 21 I_.OT::: 1 ZONE-: AGEI DISTO= G
AREA= 00000000 F/A-: F WIDTH= 100 DEPTH= 150 R/W=::
•„• OF BL_DGS•— 1 :: DWELLINGS= 1
OWNER= LA FRANCE, RODNEY PHONE= 509 928 7381
STREET= 19422 E SPRAGUE AVE
ADDRESS=:: SPOKANE WA 9901 6
CONTACT NAME=:: RODNEY LA FRANCE PHONE NUMBER= 509-928-738 i
BUILDING SETBACKS : F:RONT::: 35 LEFT::- 20 RIGHT-:: 30 REAR= 45
****************ae************ REVIEW INFORMATION **************************
DATE
DEPARTMENT NAME REVIEW COMMENTS IN/OUT INITIALS
---------------
ENVIRONMENTAL. HEALTH NEW OR ADDITIONAL WASTE WATER 870908 M
4.o,-k:i �.__._.._ -. ':. 7 ...._..._.._._.. ....._.._........ .........
______ ___
*ae .•..;.......... ....xk******* MOBILE HOME PERMIT ***************3 ****•******
CONTRACTOR:-: OWNER PHONE::::
YR/MAKE= 1987 GOLDEN WEST MODEL=
SERIALO= WIDTH== 28 LENGTH- 66 HEIGHT- 10
ITEM DESCRIPTION QUANTITY I::F:E:: AMOUNT
INSPECTION FEE 2 100..00
BUILDING SURCHARGE Y 3,50
PERMIT 'TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME: PMT 103. 50 .00 103..50
103..50 {}0 10350
PROCESSED BY : WENDEL, GLORIA
*********•*****•)**•*************** THANK YOU **** **** *****....xx.x.•u•x.**•u***
A r
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* INFORMATION WORKSHEET *
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* PARCEL NUMBER: 2-055 2-4•0440-0 l o
* STREET ADDRESS: /74/22_ S *
*
* CITY/STATE/ZIP: 6ee Gig //v4 c ile A ( vV/7�// S G/� , ! G O
**
* SUBDIVISION:Coplln./ -29/, --/Z7 eNn iii(/Q
*
* BLOCKP2J LOT: / ZONE: /Nara DISTRICT: C. *
* *
* LOT AREA:`j``0 0' F/A: WIDTH:A/C DEPTH: /5---e) R/W: *
* # OF BUILDINGS: if OF DWELLINGS: / WATER DISTRICT: 6rt/Sal(%/.e *
* OWNERS/ c,, L �'Ip�t Nq l -
/` C � PHONE: �� �2� - ? 3 �l *
*
* MAILING ADDRESS:_i - // 3/e' Sa1e,46- /e *
* CITY/STATE/ZIP: Cee 4c ,ol gw 9'701 *
*
* CONTACT: St9/i e PHONE: - -
* / / I,
* SETBACKS: - FRONT.: *
3S LEFT: .2---C, RIGHT: 30 REAR: `tS
*
* PERMIT USE: /70 l e /�/ e (i /e we *
*
******************************************************************************
* BUILDING INFORMATION *
* *
* CONTRACTOR LICENSE NUMBER: *
* *
* CONTRACTOR: PHONE: - -
* *
* MAILING ADDRESS: *
* *
* ARCHITECT/ENGINEER: PHONE: -
* *
* MAILING ADDRESS: *
* NEW:/ REMODEL: ADDITION: CHANGE OF USE: *
* DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
** BUILDING DIMENSIONS: 22 X ‘ (> (WIDTH X DEPTH) SQ. FT. : 012-
*
12-* REQUIRED PARKING: # HANDICAP: SEWER (Y/N) : HYDRANT: *
******************************************************************************
'4.i 't
w'x-- ti SPOKANE COUNTY HEALTH DISTRICT-.7•7,7-4'-gotOf
: - v� ' ENVIRONMENTAL HEALTH DI SION APPA# S 15 -
�'' R :7Ll &ee— .4 g;
�`4 � 'CTION FOR SEWAGE SYSTEM AT � +Aare.,
. _, ;: : ricai Address or Lot and Block in Plat or Section, Township, and Range/Road)
.,. .Y . may_
FC=" ' ease fill out in heavy dark line (felt-tip pen or equal) with a straight edge. Plan
-
is to include outline of structure (if available) as its position occurs on the property.
Identify by measurement actual location of septic tank, drainfield lines, drywell, or
other on-site sewage facilities, property lines closest to drainfield, on-site well
(when applicable) , driveway, road frontage. Septic tank access must be referenced to
a known fixed surface structure. _CC r-11 1 vv-e----
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('''..--:,,FINAL INSPECTION MADE BY ` /�L / /o^.R` _r...::).----
(NAME) (DATE)
COMMENTS:
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