1991, 10-22 Permit: 91007086 MH SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SBOKANIE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/application,state that thenformation contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. 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/application 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 peG,. _/ L APPLICATION/ .Z_ Q
OWNER OR AGENT "" DATE D '.2
/
PROJECT NUMBER= 91007086 ISSUED PERMIT DATE= 10/22/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 3505 N VELOX RD PARCEL= 06554-0903
ADDRESS= SPOKANE WA 99216
PERMIT USE= SINGLE WIDE MOBILE HOME -- REPLACEMENT
PLAT= 000646 PLAT NAME= DONWOOD EAST
BLOCK= 2 LOT= 9 ZONE= UR-7 DIST= Cx
AREA= F/A= F WIDTH= 80 DEPTH= 125 R/W= 50
4 OF BLDGS= 0 DWELLINGS= 1 WATER DIST =
OWNER= DEMPSEY, ELMER E PHONE= 509 924 3639
STREET= 3505 N DEMPSEY,.
RD
ADDRESS= SPOKANE WA 99216
CONTACT NAME= ELMER DEMPSEY PHONE NUMBER= 509 924 3639
BUILDING SETBACKS : FRONT= EXIS LEFT= EXIS RIGHT= EXIS REAR= EXIS
****************************** MOBILE HOME PERMIT **************************
CONTRACTOR= UNKNOWN PHONE=
STREET= UNKNOWN
ADDRESS= UNKNOWN WA UNKNOWN
YR/MAKE= 1974 BROADMORE MODEL=
SERIAL*= WIDTH= 14 LENGTH= 70 HEIGHT= 10
ITEM DESCRIPTION QUANTITY FEE AMOUNT
INSPECTION FEE 1 50.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 8.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT* PAYMENT AMOUNT
10/22/91 7880 62.50
TOTAL DUE= .00 TOTAL PAID= 6.2.50
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME PMT 62.50 62.50 ..00
62.50 62.50 .00
PROCESSED BY : WENDEL, GLORIA
PRINTED BY : WENDEL, GLORIA
******************************** THANK YOU *********************************