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1995, 09-11 Permit App: 95007143 MFH PROJECT NUMBER= 95007143 APPLICATION '^ DATE= 09/11/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 207 N SHAMROCK ST PARCEL#= 45134 .1120 ADDRESS= SPOKANE WA 99216 PERMIT USE= DOUBLE WIDE MANUFACTURED HOME PLACEMENT PLAT#= 005236 PLAT NAME= ARMSTRONG ESTATES BLOCK= 1 LOT= 6 ZONE= UR-3.5 DIST#= F AREA= 00010163 F/A= F WIDTH= 85 DEPTH= 120 R/W= 50 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = VERA OWNER= MCKNIGHT, C.W. PHONE= 509 924 2249 STREET= 207 N SHAMROCK ST ADDRESS= SPOKANE WA 99216 CONTACT NAME= CONRAD MCKNIGHT PHONE NUMBER= 509 924 2249 BUILDING SETBACKS: FRONT= 39 LEFT= 24 RIGHT= 18 REAR= 38 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING SETBACK REVIEW REQUIRED e .F(27_1E(2- C COMMENTS: ENGINEER APPROACH/ DRAINAGE/ FLOOD 909574n/S.* et IA,-1115, COMMENTS: HEALTHDIST NEW OR ADDITIONAL WASTE WATER COMMENTS: ****************************** MOBILE HOME PERMIT ***************************** CONTRACTOR= OWNER PHONE= YR/MAKE= 95/LAMPLIGHTER MODEL= SERIAL#= WIDTH= 28 LENGTH= 48 HEIGHT= 10 ITEM DESCRIPTION QUANTITY FEE AMOUNT INSPECTION FEE 2 100.00 STATE SURCHARGE Y 4 .50 COUNTY SURCHARGE Y 19.00 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING PROJECT NUMBER= 95007143 APPLICATION DATE= 09/11/95 PAGE= 02 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING MANUFACTURED HM 123.50 .00 123.50 123.50 .00 123.50 50,D• .444 * PLAT NOTE: TOPIC = CONDITIONS DEPT = BUIL► ' ******************************************************************************* BUILDINGS RESTRICTED TO 14 UNITS UNTIL PROPOSAL IS CONNECTED TO PUBLIC SEWER. BUILDING SETBACKS SHALL BE MEASURED 25 FEET FROM THE EDGE OF THE RESERVED FUTURE AQUISITION AREA. PROCESSED BY: BURRIS, ROBIN PRINTED BY: BURRIS, ROBIN ******************************** THANK YOU ************************************ i G JJII APPLICATION INFORMATION ! 5 -7 l `�3 'What is the JOB SITE address? ASSESSORS tax parcel number? A/2--,0 ? 5'/ 61 r-i /z-11e- /e' it, f- , (,) ,9-7 , 99e3 7 Legal description as it appears on the property deed OWNER or OCCUPANT Phone C_ z-/' . /1eit--r1 / 6h / Mailing address City,state Zip sr (7 ( /) s /96/ Y Who should we contact regarding this project? Phone ,9-,4 -,,,U-(4.,q What work is being done under this permit? r-1 19-t-(a r G 7-11 P-e D /74/'7€ /) /7�'/ . /7- tone :Inspector distr t Property size Rrght of way width a) N i 7 Water district ; a cua `< 0 cu Building > 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 cost of your project? Manufactured Home Sign g Width Length: What is the square footage of How high is the sign? G/-f / the sign face? Year: Make: :flier��� L,F� i7� �-IO LIT-� 2Inst4 :a: Contractor 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= 95007143 APPLICAT]:ON DATE= 09/11/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 207 N SHAMROCK ST PARCEL#= 45134 . 1120 ADDRESS= SPOKANE WA 99216 PERMIT USE= DOUBLE WIDE MANUFACTURED HOME PLACEMENT PLAT#= 005236 PLAT NAME= ARMSTRONG ESTATES BLOCK= 1 LOT= 6 ZONE= UR-3 .5 DIST#= F AREA= 00010163 F/A= F WIDTH= 85 DEPTH= 120 R/W= 50 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = VERA OWNER= MCKNIGHT, C.W. PHONE= 509 924 2249 STREET= 207 N SHAMROCK ST ADDRESS= SPOKANE WA 99216 CONTACT NAME= CONRAD MCKNIGHT PHONE NUMBER= 509 924 2249 BUILDING SETBACKS: FRONT= 39 LEFT= 24 RIGHT= 18 REAR= 38 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING SETBACK REVIEW REQUIRED e '1 Z1E,R- 9-11 c13 COMMENTS: ENGINEER APPROACH/ DRAINAGE/ FLOOD 9i/1s5-PN/I %58 6T .,J _�..../ / / ' COMMENTS: HEALTHDIST NEW OR ADDITIONAL WASTE WATER e/W COMMENTS: 9//i gj III ****************************** MOBILE HOME PERMIT ***************************** CONTRACTOR= OWNER PHONE= YR/MAKE= 95/LAMPLIGHTER MODEL= SERIAL#= WIDTH= 28 LENGTH= 48 HEIGHT= 10 ITEM DESCRIPTION QUANTITY FEE AMOUNT INSPECTION FEE 2 100. 00 STATE SURCHARGE Y 4 . 50 COUNTY SURCHARGE Y 19. 00 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING 81.7 g�, �I 141 A SPECT CATIONS /, A TYPE OF SEWAGE SYSTEM: ra 1 i J . LINEAL OR SQUARE FOOTAGE: ....__6f' ` 19- TRENCH WIDTH: 36 h _. DEPTH FROM ORIGINAL GROUND SURFACE TO BOTTOM OF SEWAGE SYSTEM: .:=,.---,/4 1 OTHER n.,z,} . / b s r, ,ia.l wC40r)LS , SIGNATU'W. ___� _- DATE__/ � ,4116111111/1121 f i 4. / Kr_}, T 1 34 to Z FLCrulkc pRo pose)) z8 J� A-RA,E RC:0'AS E w 11• +1• I2o� 1 A Ai SEwE2 / 5I �D R.JEwA� a' ___________,/"_R_ LANE 5' i -1-- — — /---- — .5 • 1 •• -'45. (o!: • 45 / fit.:„...."': ... ..c::, __/__ — — — -- — --, - — tis;it: ...V-;;;,.1 :1-!Z f '5 ...:- ...*.: , . --...,-- — — --r-i;, ,..:,:,:_.:..izi:i; x...,.: r ! 1 2, _ —,- _ - - • Iol.TiL i T� 5ASEmENT 10 i + ts:_e 1:: .t EN e.LosED ' .. :LONE: --3 ,S _ w HORD WIDTH:50. p FRONT 6„5 : � NKING: . C- /1"t ` / :OMMENT-: �_ . ,°eor, r r ecu�-r.t- ,�IcWED -��. r z [I 84-.7' 1 5' 1s---4 65' • 12' 24..` I ' / j2' I . G.:.. I 1 hs, d I b, 1 I i r 4 t . 18' o_o I • —1 if �5, 2_41 —PkI48' 1 I v 15`--ipl ail FUTURE i 3(-_, ?ROrO ED 60/N at --- -II OUSE. 28 il II ) . .4..C.-ijr.„ 'pF9�qv I - sEWER qcp� p11io 'v nZIVEWAI Dias LINE ' _ . °a I `Ib,Vi 'b' 46 unliTY 'EASEM — — ENT __ l — j,_, ', FUTURE ROAD 'DEDICAT1o1\1 y • —I_ • SHAMROCK S, , RETURN ADDRESS Home Mortgage, Usa 909 South 336th Street Federal Way, WA 98003 STATE14� or WASHINGTONDeDepartment of MANUFACTURED HOME lICEnSInG, APPLICATION PLEASE CHECK ONE fixJ TITLE ELIMINATION 0 TRANSFER IN LOCATION 0 REMOVAL FROM REAL PROPERTY 1 MANUFACTURED HOME TPO/PLATE NUMBER YEAR MAKE LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) %132533 1996 MDISN 48 X 28 115516 2 LAND ADDITIONAL LEGAL DESCRIPTION ON PAGE TITLE FEES MANUFACTURED HOME WILL BE AFFIXED ❑REMOVED Ptj%fFRTy T.X PARCEL NUMBER FILING FEE LOT BLOCK PLAT NAME 4 S4 lL SECbjTION/TOWNSHIP/RANGE APPLICATION 6 1 Armstrong Estates MOBILE HOME FEE A legal description can be obtained from the local County Assessor's Office. If there is not enough room here, use the Application Attachment form,TD-420-732,available at your local County Auditor's Office. ELIMINATION FEE Lot 6 in Block 1 of Armstrong Estates, USE TAX as per plat thereof recorded in Volume 22 of Plats, pages 64 and 65, Situate in the County of Spokane, State of Washington. SUB AGENT FEES TOTAL FEES&TAX 3 GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY It INCORPORATED UNINCORPORATED s REGISTERED OWNERS k LEGAL OWNERS Spokane 1 1 NAME OF FIRST REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER McKnight, C.W. ADDRESS OF FIRST REGISTERED OWNER CITY STATE ZIP CODE North 207 Shamrock Veradale, WA 99037 NAME OF FIRST LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER Pan American Bank 601821513 ADDRESS OF FIRST LEGAL OWNER CITY STATE ZIP CODE 1300 South El Camino Real San Mateo, CA 94402 GRANTEE(S) ADDITIONAL NAMES ON PAGE NAME OF FIRST GRANTEE DOL CUSTOMER ACCOUNT NUMBER Anyone who knowingly makes a false statement of a material I DO SOLEMNLY ATTEST UNDER PENALTY OF PURJURY fact is guilty of a felony, and upon conviction may be LAW THAT I/WE ARE THE REGISTERED OWNERS OF punished by a fine,Imprisonment,or both.(RCW 46.12.210) THIS VEHICLE AND THIS INFORMATION IS ACCURATE: SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMINATION OF TITLE/REMOVAL FROM REAL PROPERTY: X X. -20 SIGNATURE OF FIRST REGISTERED OWNER AND TITLE,IF APPLICABLE SIG TURE OF FIRST LEGAL OWNER AND TITLE,IF APPLICABLE SIGNATURE OF SECOND REGISTERED OWNER AND TITLE,IF APPLICABLE NOTARY SEAL OR STAMP NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S)SIGNATURE State of Washington Signed or attested County of before me on by Signature Printed Name of Applicant Dealer No.OR Title AND:County/Office No.OR _ __ DEALERSHIP Position/AgenVNOTARY Notary Expiration Date DEALER'S REPORT OF SALE I certify that this information is correct.The vehicle is clear of encumbrances except as shown. DEALER NAME WA DEALER NUMBER — I DATE OF SALE PURCHASE PRICE TAX JURISDICTION/TAX RATE DEALER'S AUTHORIZED SIGNATURE _ll E]USE TAX EXEMPT Sale to a Certified Tribal member on the reservation (attach notarized statement of delivery). 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 til;applicant has'.uffir,rent r lura in nrmt;rhnn In proceed with the recording of this form 1 f /i r,l•I fIAl {1 tiiiMII f S G'vATUnE DATE TD-420-729 VANUF HOME APPL(R/12/96)OR Page 1 of 2 INSTRUCTIONS AND ADDITIONAL INFORMATION ON REVERSE SIDE U 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/POSITION DATE DFinalize this application with a Licensing Agent within 10 calendar dus of the date Title Company Representative signs. BUILDING PERMIT OFFICE CERTIFICATION I certify that the manufactured home has been affixed to the real property as described,OR a building permit has been issued for this purpose and the attachment will be inspected upon completion NAME BLDG PERMIT OFFICE/PHONE 0 Cit/ ' SC/1/1 P'ric. 7 vq y5(� 3G;'7S SIGNAT E/POO TION SPOKANE COUNTYPeat-1,14f �, 7DATE DIVISION OF BUILDINGS R5-°° /11t3 1°-�`�``l� INSTRUCTIONS COMPLETE THE APPROPRIATE BOXES ON THE FORM AS INDICATED BELOW, DEPENDING UPON THE TRANSACTION YOU WISH TO PROCESS. A. Manufactured Home Title Elimination Application(complete boxes 1,2,3,4 and 6). Use to eliminate a title for a manufactured home which is to become real property. B. Manufactured Home Transfer In Location Application(complete all boxes). Use only when a manufactured home(whose title has been eliminated)is being moved to land with a different legal description AND will become part of the real property to which it will be moved and affixed. If the transfer in location is between two different counties,prepare this form in duplicate and have each recorded in its respective county. C. Manufactured Home Removal From Real Property Application(complete boxes 1,2,3,4 and 5). Use when titling a manufactured home whose title has been previously eliminated. Once properly completed and recorded, this application becomes a supporting document along with others required to apply for a Certificate of Title for the manufactured home. IMPORTANT: SIGNATURES OF THE OWNERS ON THE MANUFACTURED HOME APPLICATION INDICATE TERMINATION OF INTEREST IN THE MANUFACTURED HOME THROUGH TITLE PROVIDED BY CHAPTER 46.12 RCW AND INDICATE INTENT TO PERFECT INTEREST IN THE MANUFACTURED HOME AS REAL PROPERTY WITH THE LAND HE/SHE/THEY OWN AND TO WHICH IT IS/WILL BE AFFIXED. IF THE MANUFACTURED HOME IS BEING REMOVED FROM REAL PROPERTY,SIGNATURES OF THE OWNERS PER THE REAL PROPERTY RECORDS INDICATE CONSENT TO THE REMOVAL. THE FORM MAY THEN BE USED FOR MAKING APPLICATION FOR TITLE WITH THE DEPARTMENT OF LICENSING AS PROVIDED BY CHAPTER 46.12 RCW. Note: Owners of the manufactured home must own the land when the application is for a Manufactured Home Title Elimination or a Manufactured Home Transfer In Location,as provided by Chapter 65.20 RCW. SECTION 1 Enter the description of the manufactured home. SECTION 2 Place an"X"in the appropriate box and enter the property tax parcel number,lot,block,plat number and section/township/range,when applicable.Write a legal description in the space provided.If there is not enough room, use the Title Application Attachment(TD0420-732).When processing a"Transfer in Location Application,"both boxes should be checked.The application must then be accompanied by two separate land descriptions. SECTION 3 This area must be signed by all registered owners of the manufactured home when processing a title elimination. If the manufactured home has been sold and is being removed from the real property,the owners per the real property records must complete this portion to obtain a Certificate of Title. Signatures of the owners must be notarized or certified by the selling dealer or a vehicle licensing agent. Fees will include a filing and application fee plus sales or use tax due. Additional fees may include:a title elimination fee and a Mobile Home Affairs Fee. Subagents will charge an additional service fee. (Fees are subject to change without notice.) SECTION 4 Take the properly completed Manufactured Home Application and all necessary supporting documents to the County Auditor/Licensing Agent Office for approval. Supporting documents may include but are not limited to: proof of ownership or a Manufacturer's Statement of Origin(MSO),proof of taxes paid,and applicable release(s)of interest. Subagents may not complete the approval portion of this form. SECTION 5 The'Title Company Certification"box must be completed when processing a'Transfer In Location"or a"Removal From Real Property"application. Important: The final recorded application form must be submitted to a vehicle licensing agent within 10 days of the title company's certification. SECTION 6 When processing an"Elimination"or'Transfer In Location"application,a city or county office (depending upon the location of the manufactured home)must certify that the home is affixed to the land;or,issue a building permit to affix the manufactured home to the land,inspecting the completed attachment. The issuing office must sign the application,adding the permit number if the inspection has not yet occurred. IMPORTANT: Once the application has been approved by the County Auditor/Licensing Agent Office,take your application form to the County Recording Office. Retain proof of the recording fees paid. If the Recording Office retains your original application form,obtain a certified copy of the recorded form. APPLICANTS: Once recorded,you must return to a Vehicle Licensing office to file theManufactured Home Application, paying all required fees.