1990, 05-14 Permit: 90002046 MH SPOKANE COUNTY nEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY-AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/application,state that the information 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 canc-I the pr/visions of ny st or local law regulating construction,oras a warranty of conformance with the provisions of any state or local
laws regulating construction,1
SIGNATURE OF i/I b/ APPLICATION
OWNER OR AGENT DATE
.. q
?••=?•=_1 I.tt^1..: 1 NUMBI;::R= 9St�:002.04,? a.x.. .V y::!. ...ct`• •,:t PAC.,. •:t'!
*****H******************* ** EERMIT '::'Li c:, * .:r.:j.: !.:!j..r:!r.:M* t.:!}.a;'.s;::;t:r.* }::,.•*
ry t••U,f?'.?!(•± ? .?.t•,�t`d R•1k 4;•�•..-.rt 9r;r)t!.t. r.r...)...!.r.r. :.:..t/...!. ... !.
SITE STREET= 4111 ,, ?e? i i U Ft. RD 1^`ri!i•t. •i'I :'•„+:-.. 33544-011
ADDREE= • •-"t..tt', ar_ WA 9:+206
PERMIT U I 1.:.:::: SINGLE WIDE i'•5c:t:: .I.I._I:', HOME .... REPLACEMENT
PLAT.,;..... 002651 PLAT NAME= ? OMI. I+ j+,x ADD ! O CHESTER Sf
f ER
BLOCK= LOT= S..1.7?��:�.".. F'i�•7 I•'j.�. .??J f\ •,,•__
AREA=(.:t:::: WIDTH= 21 : DEPTH= Ci r 1i 1,.1::::
OWNER_:::. i::- •;f.,t : ; i':? ANDERSON PHONE= 509 922 3365
STREET= .i :I .I W.I.I._iIi.1 t RD
ADDRESS= SPOKANE W(. 99206
CONTACT NAME= I..1ARi_I1...D.% ,.f I.•i:t;j v IF is PHONE H i.� ?` ?' !:11, '.:i`,':.;1::?;:.::: ,...:•.:•i 922 7.365
BUILDING SETBACKS : FRONT= E:.I-.,. ..F.:• ._ E. .j, RIGHT= . REAR= ,
LEFT=
4+:;t•*:k**•P:P:K ** '•****f{..pi**•Pi;n* .Pi:ri..j+..1;.* MOBILE t m t ' ************************4..
CONTRACTOR= OWNER PHONE=
- YR/MAKE= 1974 CAMERON MODEI
• 'ITEM EM DESCRIP tIi tN QUANTITY FEE AMOUN....
INSPECTION FEE 50.00
'':"••7 ATE S1_IRl.:I••I#`:Ri..vI::. '! '_f ,.':iiii
COUNTY SURCHARGE
,00
.j .. ...!..Pjp:. k*; **atyy *: ru.ra . ; i : . ra iPAYMENT .} rrn: : ! : : :rr
r? rKas * t kr; rr *a
r
PAYMENT
i: :N , AT _ , : , ' IIfl PAYMENT A' ?tNT
05 1'I 90 7.. 62.50
•
TOTAL t AL f+UE:::: 00 TOTAL PAID= 62.. 50
AMOUNTPERMIT TYPE FEE OU.�? PAID AMOUNT OWING
•
.. :t::' 5
?'?�.�{:.#.?. ?::. ?"lit#'?!... I"';? ? }.c...::'7;;I 62. 50 00
62..50 62..50 ..00
PROCESSED E,.',x,>!. D ?:� T t ?:..{,i,_EL..; GLORIA
PRINTED BY : WEND,).. GLORIA
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