1987, 09-10 Permit App: 87002971 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
PROJECT NUMBER= 87002971 DAATE-: 09/10/87 PAGE= 01
aE******•tt*3*****•*****•x•x*•*******x*** APPLICATION *•ua+***3cx*•x*••**•x•**•x** •m:ar...;k•tt••p:••x•nai*
SITE STREET= 2505 N W:C LBUR RD PARCE.L..:p= 09541 —20 i i
ADDRESS:-: SPOKANE WA 99206
PERMIT USE= DOUBLE WIDE MOBILE HOME (REPLACEMENT)
PLATO= 000762 PLAT NAME::: FAIR ACRES MOBILE HOME ADD.
BLC)CI<.::: i L_OT::: 2 ZONE::-- RMH DJ ST:a= F
AREA= 00000000 }:•i A=:: I::• WIDTH= i'') DEPTH= .I 1 5 R.'W=::
:I; OF I::I...DiYS:::: 4 DWELLINGS= i
OWNER= M1LL:I:KIN , 'i;, PAUL.. H PHONE= 509 924 8990
STREET= 2505 N W:I:I._BUR RIS
ADDRESS::: SPOKANE:: WA 99206
CONTACT NAME::::: OWNER PHONE NUMBER= 509-924-8990
BUILDING SETBACKS : FRONT= 40 LEF...i.:::: RIGHT= 6 REAR=
*3t•r:*ae*x***b•r:•u•**•n ••u xyt•**•xaek•**at• REVIEW INFORMATION •x*ac••xxx•ye•x•#*k**•utt•r:•xlik•)r.•x•ae•x •*x•
I)ATE
DEPARTMENT NAME REVIEW COMMENTS IN/OUT INITIALS
ENVIRONMENTAL HEALTH • " /EASilk: IN LOT O"vi E*i!Ac : 13.10910 Gt':YM
/4/ ._ . ............"k. .r?_......._
*•r!•?r.•ar* ytat*•u***•x*n** ••u**** xis* MOBILE HOME PERMIT N***•*****•it***•*•X.1(..•11*3 •k•iE3f7i'r•)i
CONTRACTOR::: OWNER PHONE=
YR/MAKE=•N•••- 81 MODUL I NE:: MODEL= y LENGTH=��E..R.LALWIDTH= 24 LENGTH=TH56 HEIGHT= 10
PROCESSED BY : MILLIARD[, CrODOL..I IN
h:****X•*)i•***•M**li***3 **•li•1t k•)i••1{•lt**•** THANK YOU * *•}kN•)t• •**a!u)E**•lik••ri3t••*.x3(•)t•3(*•1f**k 7t•*•N*
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* INFORMATION WORKSHEET
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* *
* PARCEL NUMBER:
* *
* STREET ADDRESS:
* *
* CITY/STATE/ZIP:
* *
* SUBDIVISION:
* *
* BLOCK: LOT: ZONE: DISTRICT:
* *
* LOT AREA: ‘F/A: WIDTH: DEPTH: R/W:
* *
* # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
* i *
* OWNER: PAUL- f� M �.�.1KiN �R , PHONE: -9a)-1 -Fs9ctc
* MAILING ADDRESS: N . '-A 5a 5 u.i D
* *
* CITY/STATE/ZIP: SFC 4NE iN Qc{ ;�CG
* }
* CONTACT:PAi 1- N , L i'14)1.--1 R . PHONE: - - *
*
* . SETBACKS: - FRONT: LEFT: RIGHT: REAR:
* PERMIT USE: Z4 ' 11106tkE 61 Mo P u LA f'J E *
* *
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* 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: X (WIDTH X DEPTH) SQ. FT. :
* *
* REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT: * '
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