1990, 08-29 Permit: 90004047 MH 4
SPOKANE COUNTY DEPARTMENT 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 cancel the provisions of any state or local law regulating construction,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF `r/iL� APPLICATION �_ 7 ?0,OWNER OR AGENT DATE
PROJECT NUMBER :: 90004047 DATE= 0e/29/90
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E HED+ PERMIT
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a (EI I';:!::.t: i = 625 i'',i W' I i u L t a iJ j`,1 I"`:(i t:::r;?1: f • 15543-0107
ADDREE::;- EPOKANE WA 99216
PERMIT+ .; E - DOUBLE WIDE MOBILE HOME FOR DEPENDANT RELATIVE
Bt.. 14.= L..0 T :ZONE= AG,EU B i.1.!.:i• 1 7i:x:
(#!':t•:.f.t:::: 000000''' /(.'.f::a F WIDTH (:i DEPTH= 100 R/W= 50
OWNER=:?Et,...... ,+1"1ER140?3D I(3HN D Pt1!i,.I#: 509 928 1610
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ADDRESS- :S t''l.)Y-,t••s ttJ E WA 99216
CONTACT Nf=#I'1F..::. MARCIE 'i : WOt1
RIGHT=PHONE
NUMBER=
928i t
BUILDING SETBACKS : ON : :rLEFT=: iaftiiREAP 30
,..• ... F E E NI..
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CuNIRACiOR= OWNER PHONE=
•
•
• YR/MAKE= 1990 MODFi =
,.:....t'S.t...'!. .,,....' W.t.t,t ? #.'?..... 00 LENGTH= 00 J !"!#:'. ?.t. _'! 1 :::: 0
ITEM DESCRIPTION - QUANTITY
FEE - AMOUNT;yM#:iii T
INSPECTION FEE - 100„00
STATE SURCHARGE 4 , 50
COUNTY SURCHARGE E .+ 16 ,00
f. ,1•.F.,. F.1.* 1.J.t,1.3!J.,!3!t!..3,,.,j..,;,ji•j(. !'ir-'}?•9?•t?•9!•i+£. _6. 7 7"1-'`1:- ,#,:::.,••.-.: :k*** **** *********** *****
t .1 I....t� f ,.:t.�t"t t'ry(..}#•,,, Y !:• 1•!t•
PAYMENT;.,;,...N..,_ ,;,....
PAYMENT DATE!::. i'.t:'.#..:f::..t.!" i„• •,,
08/29/90 5098 120, 50
•
TOTAL Dt.i1-:::: ;:,"' •i••O••:•., PAID= 120,50
• PERMIT t :I ! FEE AMOUNT " " i[ NPAID AMO
i rOWING
; 'i
.
•
MOBILE HOME PMT 120,50
120,50 1 +:%..5!:.1 1 0
PROCESSED B Y : •..f t..;i....!.?::. SHATTO
PRINTED t_,Y . WEN ,!E L; GLORIA
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