1991, 11-06 Permit: 91007635 MH SPOKANE COUNTY DEPARTMENT OF BUILDINGS
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 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 97
OWNER OR AGENTgitr1/4 /1 DATE
... .,,i, .......,.,. NUMBER= 91007635 ISSUED ..T r.•
di: : : : j: , : : : : : : . . ) ajrs ) h ) K :rR I T INFORMATION *
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SITE STREET= 913 E WILLAMETTE ET PARCEL4= 23533-3107
ADDRESS= SPOKANE WA 99212
PERMIT USE= INSTALL DOUBLE€'fLE 4 ,7j , MOBILE t E
PLATO= 003533 PLAT NAME== t• !...€CET GROVE
.,
BLOCK= { i-{ ; .... t rrt'1ks'�•— € ::?., ... DISTO=
(•t:;!::.P:€:::: €..;.(.:€= WIDTH= DEPTH= N/W= 50
SPOKANE,
0 t... st.....?ts,::-- 4 DWELLINGS= •t WATER DIST = CITY OF
OWNER= !. t, RANDY ,ter SHELLEY PHONE= 509448 tr a. 6
STREET= 12115 ,; f:r-a 4...!...t....7 t.:{;(-11"t::.S.. RD
ADDRESS= VAIIFYFORD WA 99036
CONTACT€ NAME= RANDY ALTMEYER PHONE NUMBER= ?"j i 448 7323
BUILDING SETBACKS : €••Rt€i i .. 35 LEFT= 16 RIGHT= 26 REAR= 39
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ITEM DESCRIPTION I•{i,} ) , t ! €:.E€.. AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE 4.50
COUNTY SURCHARGE 7� 16,00
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PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
11 /06/91 8 ...... 120.50
TOTAL t tl!... Dt.U!::.:::: ,t?±;) TOTAL€ € (..i!... €.:l.i.!..}:::: 120.50
PERMIT ! Yr'E FEE AMOUNT AMOUNT PAID AMOUNT OWING
-f 0 Y:'!.!...E HOME PMT 120.50 i 2 ..50 ..00
14 '0.,50 120.5E) .00
PROCESSED BY : jOHN LARSON
PRINTED BY : jOHN LARSON
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