1987, 09-28 Permit App: 87003212 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 g / this of work will be complied with whether sified herein or not.I understand that the issuance of this permit and au ent 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= 876O32i2 DATE= 09/28/87 PAGE= Oi
************ **************** ** APPLICATION ******************************
SITE %TREET= 18714 E VALLEYWAY PARCEL4= i7553-28O4
ADDRESS= GREENACRE% WA 99016
PERMIT U%E= SINGLE WIDE MOBILE HOME
PLATt= 002442 PLAT NAME= %OUTHERN ' % MOBILE PARK ADD
BLOCK= 2 LOT= 4 ZONE= RMH DI%TO= �
AREA= OOOOOOOO F/A= F WIDTH= 68 DEPTH= 147 R/W= 50
:II, OF LINGS-
OW NER= BAHRADREEN PHONE= 509 924 1174
STREET= 1512 % WOODWARD RD
ADDRESS= SPOKANE WA 99206
CONTACT NAMEPOREEN BAHN r PHONE NUMBER= 509-924-141
BUILDING FRONT= 3z LEFT= 7-m RIGHT= - REAR= �,Y'
****************************** REVIEW INFORMATION ***************** ********
DATE
DEPARTMENT NAME REVIEW COMMENTS IN/OUT INITIALS
--------------- --------------- ------ --------
COUNTY ENI NEERNEW COUNTY D APPROACH� �MW
/
------------------------------ --- -- ---
ENVIRONMENTAL HEALTH NEW OR ADDITIONAL WASTE WATER 870928
QV----------- �------------ ��4��-�/ « ---
------------------------------ ------ ---
***** ********************* ** MOBILE HOME PERMIT **** ****************** **
CONTRACTOR= OWNER PHONE=
YR/MAKE= 1985 %EQUI8A MODEL=
%ERIALt= WIDTH= 14 LENGTH= 60 HEIGHT= iO
PROCESSED BY : WENDEL' GLORIA
******************************* THANK YOU *********************************
** r *****************************x***********************************
* INFORMATION WORKSHEET
*************************************************************************
*
* PARCEL NUMBER: /7553 - 2-F3o
* STREET ADDRESS: /8-7a 44 LL
* CITY/STATE/ZIP: ggc) c ,
* SUBDIVISION: z-r 14 G420'S ma<<C ►`iiak#e
* BLOCK: Z LOT: Lk. ZONE: DISTRICT:
* LOT AREA: F/A: WIDTH: DEPTH: R/W:
* *
* # OF BUILDINGS: # OF DWELLINGS:
* OWNER: ," ( _,,li �3�/w PHONE:
* MAILING ADDRESS: _ r3
* *
* CITY/STATE/ZIP: 4: .74al G!/Q. .
* *
* CONTACT: PHONE: - -
*
* SETBACKS - FRONT: LEFT: RIGHT: REAR:
* *
* PERMIT USE: S 1 V im'- -- W/ Dom.
*
*************************************************************************
* 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: # HANDICAP: SEWER: (Y/N) : HYDRANT: *
*************************************************************************
********##**4*X #****#*#4*4*#X#t444*********##* 44#44 ###*4*******vv**V**4#4__**
NGPILE FCNE INECRNATICN NI , *
* CCNTR LIC+t :
* *
* CONTRACTOR : PHONE :
*
* MAILING ACCRESS : *
* PREVICLS ADDRESS :
*
* LOCAT IGN : FAhCEL NLNEEP :
* *
STREET :
* CITY/STATE/ZIP :
*
MAKE : lCfE5 E C1iICA UCDEL :
* SEPIALk : 1` IDTF : f( LENGTF :_
4#**T K Y*; Y * * 4 4 4 h * 4 4 *4 ** * Y***T*****f#*Y*** Y*****Y*4******# *#********c 4********
* RELCCATICN INFCRNATICN *
• CONTR LIC # :
* CONTRACTOR : ---- FFCNE :
* *
* MAILING .AJLRE5S : 4
* PREVIOUS ACDRFSS :
• LLCATICN : PARCEL NUMBER : 4
* Y
* STREET : *
* CITY/STATE /ZIP :
* T
****#* **4#*4 CSX X4* 4444*********#44#****#****** *#**#****#**##**44***#***###***#*
* SIGN INFCI t'ATICN * •
* CONTR LIC :__.. *
* CONTRACTOR : FFCNE: - - *
* MAILING ADDRESS : *
* *
* SCUARE FOOTAGE: FCLE FEIGHT : *
4
* *
************** *s***44c##************#******************************************
* DEMCLITICN INFCRNATICN
* CONTR LICk :
* CONTRACTOR : FhCNE:"-_---- _ *
* *
* MAILING ADDRESS : _ *
* *
* BUILCING SCUARE FOCTACE :
* #
NUMBER CF BUILCINGS :__
* . *
************x*****************************************************************
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