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1995, 06-05 Permit App: 95003936 MFH
PROJECT NUMBER= 95003936 460APPLItATIOV DATE4,6/05/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 202 N SHAMROCK ST PARCEL#= 45134 .2318 ADDRESS= SPOKANE WA 99216 PERMIT USE= NEW TRIPLE WIDE MANUFACTURED HOME PLAT#= 005236 PLAT NAME= ARMSTRONG ESTATES BLOCK= 2 LOT= 18 ZONE= UR-3. 5 DIST#= F AREA= 00012516 F/A= F WIDTH= 90 DEPTH= 140 R/W= 50 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = VERA OWNER= LIEN, KENNETH L & ANNETTE C PHONE= 509 921 1442 STREET= 10623 E SPRAGUE AVE ADDRESS= SPOKANE WA 99206 CONTACT NAME= KENNETH OR ANNETTE LIEN PHONE NUMBER= 509 921 1442 BUILDING SETBACKS: FRONT= 30 LEFT= 30 RIGHT= 5+ REAR= 30+ ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING SETBACK REVIEW REQUIRED c / �� q fa COMMENTS: rl ,____, - � t---- ��EERo,., APPROACH/ DRAINAGE/ FLOODfJ�/} �,� / #114p,/ /� 1 I, l 0 COMMENTS`: l j �" p�0 �e 01/.4 b'+¢' �wGO-A / L/ / 1 HEALTHDIST NEW OR ADDITIONAL WASTE WATER i ei COMMENTS: ****************************** MOBILE HOME PERMIT ***************************** CONTRACTOR= OWNER PHONE= YR/MAKE= 1995 SILVERCREST MODEL= BUCKHINGHAM SERIAL#= WIDTH= 39 LENGTH= 61 HEIGHT= 00 ITEM DESCRIPTION QUANTITY FEE AMOUNT INSPECTION FEE 3 150 . 00 STATE SURCHARGE Y 4 . 50 COUNTY SURCHARGE Y 27 . 00 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING fiN PROJECT NUMBER= 95003936 APPLICATION DATE= 06/05/95 PAGE= 02 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING MANUFACTURED HM 181. 50 . 00 181. 50 181 .50 . 00 181 .50 PROCESSED BY: JULIE SHATTO PRINTED BY: JULIE SHATTO ******************************** THANK YOU ************************************ APPLICATION INFORMATION What is the JOB SITE address? ASSESSORS tax parcel number? J- ,„Y,)//9-1(>20°C_ l Legal description as it appears on the property deed OWNERyyr OCCUPANT Phone /(79/.2--- Mailingaddress City,stale Zip / ��1z- /4a-e__ Who should contact regarding this project Z. Phone / N/1) 02 ,A7Le_tr-e ,(�Ls�✓ �9— —/cis/ What work is being done under this permit? ... Inspector district Property size Right of way width O m q M +c.a. 0. m 0Gim Builds ? `>';:•.; Building height #of stories Contractor Dimensions TOTAL SQUARE FOOTAGE WA State Contractor license* Main floor area Unfinished basement area Mailing address 2nd floor area Finished basement area Architect/Engineer Garage area Size of decks,etc. What is the heat source? What is the coat of your project? Manufactured Home Sign Width: Length: What is the square footage of How high is the sign? 9 r /O , / _ /i Year: Make: the sign face? �f, /99 S �'�ed4Ot, r -t (Be-0, Installer Contractor /(..if 4-14-6 s Wa State Contractor license# Wa State Contractor license# Mailing address Mailing address Relocation Fire-Safety Previous address Fire Sprinkler Tent _ Paint booth_ Fire Alarm Fireworks display VALUE Contractor Contractor WA State Contractor license# WA State Contractor license# Mailing address Mailing address Fuel Storage Tanks Swimming Pool' (Circle one) Above-ground Underground Size/gallons Private Contents of tank(s) Size/gallons Public/semi-private Contractor Contractor Wa State Contractor license# WA State Contractor license# Mailing address Mailing address COMPLETE ALL APPLICABLE INFORMATION Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities. PROJECT NUMBER= 95003936 CPPLIcIOaN DATE,1 )6/05/95 PAGE= 01 ****** 1 IS IS NOT A PERMIT ****** PENALTIES WILL BE AS E SED .'OR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 202 N SHAMROCK ST PARCEL#= 45134 .2318 ADDRESS= SPOKANE WA 99216 PERMIT USE= NEW TRIPLE WIDE MANUFACTURED HOME PLAT#= 005236 PLAT NAME= ARMSTRONG ESTATES BLOCK= 2 LOT= 18 ZONE= UR-3. 5 DIST#= F AREA= 00012516 F/A= F WIDTH= 90 DEPTH= 140 R/W= 50 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = VERA OWNER= LIEN, KENNETH L & ANNETTE C PHONE= 509 921 1442 STREET= 10623 E SPRAGUE AVE ADDRESS= SPOKANE WA 99206 CONTACT NAME= KENNETH OR ANNETTE LIEN PHONE NUMBER= 509 921 1442 BUILDING SETBACKS: FRONT= 30 LEFT= 30 RIGHT= 5+ REAR= 30+ ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT LAIZi)BUILDING SETBACK REVIEW REQUIRED t `� ��1 1 OMME T S: �-GJ __ "' q s %1' $ 3ENGINEEDR, APPROACH/ DRAINAGE/ FLOOD ' . �$ �'"di(741/ ,o, COMMENTS: / , :t ,, 1- / / / z -1" '20 (1,41 .�, 11 DV dli9 I ,t,�f..F.7. ' . / / • M/ A HEALTHDIST NEW OR ADDITIONAL WASTE WATER n 1. 6 -,..1e--2- s-- %'C,u COMMENTS: ****************************** MOBILE HOME PERMIT ***************************** CONTRACTOR= OWNER PHONE= YR/MAKE= 1995 SILVERCREST MODEL= BUCKHINGHAM SERIAL#= WIDTH= 39 LENGTH= 61 HEIGHT= 00 ITEM DESCRIPTION QUANTITY FEE AMOUNT INSPECTION FEE 3 150. 00 STATE SURCHARGE Y 4 .50 COUNTY SURCHARGE Y • 27 . 00 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING "' 4.4 Go rage,/ 'nJorrshof, fte Q_ w ive(c(e l-� _�u.ckin.5kom 3E -II ,3- edroom R s dent SS A • , Z Z FLANKING ROAD WIDS: GUMMA aF«�EW' 1✓U We //15, •Sfr(DO ms or,1Oohc/s / /a //cc/ sir o n E 7 7` 0s PrP//m;nar /67ct?'" Oan Road V,'d A - So P74, r, �Q r by 3 i to oa'j ow/tiers': i%nnet/ L. L,e,v, A,V?eie C. L;P.v, hos'', 4-4,141e 1 Lof /8', 8/ock 2 - 4rmstrapier c ale, tr.": /P I o ° Contact Oddie r C, /OG 23 -Sprat ju''I? u• .'0 ° 51004'0,7P, W/V, ?9a 06 I s -• I. (So9) Qat-/4x4/.. 61C22a, 2, /79 L41STATE2F„WASHINGTON RECORDER'S CLOCK FILED AT THE REQUEST OF: (� Deparffof MANUFACTURED HOME liCEnsinG APPLICATION NAME Please check one ADDRESS TITLE ELIMINATION(Complete all but section 3,below) T1 TRANSFER IN LOCATION(Complete ALL sections below) REMOVAL FROM REAL PROPERTY(Complete all but section 4,below) 0 MANUFACTURED HOME TPO/PLATE NUMBER YEAR MAKE WIDTH/LENGTH VEHICLE IDENTIFICATION NUMBER(VIN) 1996 BUCKINGHAM 39 'W..X 64 'L 17709290 — A © LAND Attach a copy of the legal description of your land. It can be obtained from your County Assessor's office or it may be typed or printed on an Additional Attachment Form (TD-420-732). PROPERTY TAX PARCEL NUMBER Manufactured home will be XX AFFIXED 1 I REMOVED 45134 . 2318 © TITLE COMPANY CERTIFICATION I certify that the legal description of the land and ownership is true and correct per the real property records. NAME TITLE COMPANY/PHONE NUMBER SIGNATURE DATE X• Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. 4 BUILDING PERMIT OFFICE CERTIFICATION I certify that the manufactured home has been affixed to the real property as described, or a building BLDG PERMIT# per it has been issued for this purpose and the attachment will be inspected upon completion. �1SOO 3(p NA E IGNATURFJTITLE SPOKANE COUNTY BL G PERMIT OFFICE/PHONE# DI / / DIVISION OF BUILDING AND PLANNING (�l +S //' /O /R OW ER INFORMATION J (D V EES t/ t --- COUNTY# INC UNINC #REGI RED OWNERS a LEGAL OWNERS Provide the Washington Driver's License or I.D. FILING FEE I 1 lx1 2 2 card number(PIC)for each owner: ' NAME OF FIRST OWNER APPLICATION R E KENNETH L. LIEN o NAME OF SECOND OWNER I MOBILE HOME FEES s ANNETTE C. LIEN EADDRESS OF OWNER ELIMINATION E 202 NORTH SHAMROCK STREET OR if the owner is a business, D CITY STATE ZIP CODE provide the Unified Business USE TAX VERADALE WA 99037 Identifier(UBI),found on the business Registration&Licenses I NAME OF FIRST LEGAL OWNER' Document. SUB-AGENT FEES L 1 SANTE AS RF_GTSTEB O OWNER MAILING ADDRESS OF FIRST LEGAL OWNER More than two owners or one TOTAL FEES&TAX N p SAME, AS RF.(;TSTERF.f) OWNER lienholder? Please use attachment 0 CITY STATE ZIP CODE form(s) #TD-420-732. $ I E DEALER'S REPORT OF SALE R 'SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMINATION OF TITLE/REMOVAL I certify that this information is correct. The vehicle is clear FROM REAL PROPERTY: X of encumbrances except as shown. Anyone who knowingly makes a false statement of a material fact is guilty of a felony,and WA DLR NO. DATE OF SALE PURCHASE PRICE upon conviction may be punished by a fine of up to$5,000 and/or 10 years imprisonment $ (RCW 46.12.210). I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY LAW THAT I/WE ARE THE REGISTERED OWNERS OF THIS VEHICLE AND THIS INFORMA- DEALER NAME TAX JURISDICTION/TAX RATE TION IS ACCURATE: Owner Signature(s)a Title(s): WOMACH ' S HOME SALES X DEALER'S AUTHORIZED SIGNATURE X X USE TAX EXEMPT Sale to a Certified Tribal member on X the reservation (attach notarized statement of delivery) JOTARY OR LICENSE AGENT&NUMBER SUBSCRIBED TO AND SWORN BEFORE ME THIS Residing in(County) X DAY OF 19 6 COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL:(Not for use by Sub-Agents) I certify that the above application appears to have been completed correctly, and the applicant has sufficient documentation to proceed with the recording of this form. VAME SIGNATURE I OFFICENFS OPERATOR NUMBER DATE X .. )-420-729 MANUF HOME APPL(R/2/94)M Page 1 of 2