1987, 09-29 Permit App: 87003238 MH 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
°"1'+-.O,_'•E`. ' NUMBER= 8 :0{:.':: DATE= ..
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SITE STREET= 16710 E VNAFYWAY PAprEL0= i7":":;2-2R02
ADDRESS= ,.R+::'I:.i:j ;CI:;'i:-c WA ?t}`Ji.!"i ,
PERMIT USE= DOUBLE WIDE MOBILE HOME
' 1..,A i .:...... 002442 PLAT NAME= ::':•O U ! i'.I::.R!': ... MOBILE PARK A i
AREA:— 00000000 :;:' h WIDTH= 66 DEPTH= ii5 I•+;:'i;!:::: r.:
i .i: BLDGE= i :1: DWELLINGS=
OWNER= ,+: I"i €.: I ;i,,•,j ;: H I 'i ':° I.:I- !,i i-'.::::
STREET= I::' t± BOX s":i'.;.
ADDRESS= i.rr°•.i::.'.. t i..:REE frit 99016
CONTACT NAME=.._ ,.t?s,N1::.1"'-: PHONE NUMBER=
BUILDING :::,... t 1.+€"!i.:i`•.:.: f-1''.;i l N {�:... ... ... ......... i :... 16 RIGHT= REAR= 25
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DATE
. . ( , , . : , NAME . d COMMENTS ! • . . INITIALS
COUNTY NGIe .. i N± C COUNTY ; _ L APPROACH
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PRIVATE ROAD 870929 GGM
ENVIRONMENTAL HEALTH N 1::.C}:€ OI k A..i 1::; ..i.c:)N A 1... WASH..... IE!€..! ! EI?, 970929 rcr
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YR/MAKE= 85 NASHUA MODEL=
SERIAL-4= WIDTH= 24 LENGTH= 50 HEIGHT= 10
PROCESSED F-, , ,it.:€:.. ....:.!±...i i.. '_Y OJ.i 1...:.... ..!•'!
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* INFORMATION WORKSHEET *
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* ( 755 Zg° ti *
* PARCEL NUMBER: 18-7 10 , U-M/l.' (�u j C -2-v :
*
* STREET ADDRESS: *
* *
* CITY/STATE/ZIP: r *
* c>o U-r 7'- J /yl o o vt •{-tyv\'G 01501,4‹... *
* SUBDIVISION: A s' i i'" °' f
* *
* BLOCK: LOT: �o ZONE: `-"/114 DISTRICT:
* LOT AREA: F/A: WIDTH: DEPTH: R/W: *
* *
* # OF BUILDINGS: # OF DWELLINGS: *
*
/V
/
* OWNER: Cfig� /4� � /,,//��'S_ //f!C'fjU S-0 i2/ PHONE: - -
**
* pb
* MAILING ADDRESS: 1• t 0 Lac *
* *
* CITY/STATE/ZIP: (nr�' E CxG r� t4' c C) C b *
* *
* CONTACT: PHONE: - - *
* *
* SETBACKS - FRONT: LEFT: RIGHT: REAR: *
* PERMIT USE: " cb M061/1E7- R-011 gr 4.4441/P‘J44't/PS *
*
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* BUILDING INFORMATION *
* *
* *
* CONTRACTOR LICENSE NO. : *
* *
* CONTRACTOR: PHONE: - - *.
* *
* MAILING ADDRESS: *
* *
* 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. *
* *
*REGUIRED PARKING: 1 HANDICAP: SEWER: (Y/N) : HYDRANT: *
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