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1995, 12-20 Permit App: 95010498 MFH PROJECT NUMBER= 95010498 APPLICATION DATE= 12/20/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 304 N SHAMROCK ST PARCEL#= 45134.2318 ADDRESS= VERADALE WA 99037 PERMIT USE= NEW TRIPLE WIDEMANUFACTURED HOME W/GARAGE PLAT#= 005236 PLAT NAME= ARMSTRONG ESTATES BLOCK= 2 LOT= . 6 ZONE= UR-3.5 DIST#= F AREA= 00012218 F/A= F WIDTH= 90 DEPTH= 136 R/W= 50 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = VERA OWNER= GIBLER, FRANK D PHONE= 509 926 5874 STREET= 15910 E 11TH AVE ADDRESS= VERADALE WA 99037 CONTACT NAME= FRANK GIBLER PHONE NUMBER= 509 926 5874 BUILDING SETBACKS: FRONT= 30 LEFT= 30 RIGHT= 15 REAR= 10 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING PLAN REVIEW REQUIRED COMMENTS: BUILDING SETBACK REVIEW REQUIRED 41117' COMMENTS: l�- - ENGINEER APPROACH/ DRAINAGE/ FLOOD q cf/LIG j6l *10/9.S - 710r COMMENTS: HEALTHDIST NEW OR ADDITIONAL WASTE WATER _p( COMMENTS: 0GC. / 6I/ Nick) ******************************* BUILDING PERMIT ******************************* CONTRACTOR= OWNER PHONE= NEW= X REMODEL= ADDITION= CHANGE OF USE= DWELL UNITS= OCCUP. LD= BLDG HGT= 8 STORIES= 1 BLDG W X D = 24 X 36 SQ FT= 864 SPRINKLER= N REQ PARKING= #HANDICAP= CRITICAL MAT= N . c2/-1o3- Y75-o92-.J— STAT£OF WASHr.NGTON MANUFACTURED HOME RECORDER'S CLOCK FILED AT THE REQUEST OF: liCEnsinG APPLICATION NAME Please check one ADDRESS X . TITLE ELIMINATION(Complete all but section 3,below) TRANSFER IN LOCATION(Complete ALL sections below) REMOVAL FROM REAL PROPERTY(Complete all but section 4,below) Q MANUFACTURED HOME TPO/PLATE NUMBER YEAR MAKE WIDTH/LENGTH VEHICLE IDENTIFICATION NUMBER(VIN) 1996 Silvercrest 6-7 X A.-- 177 J GJ Gil -7 '-A © LAND Attach a copy of the legal description of your land. It can be obtained from your County PROPERTY TAX PARCEL NUMBER Assessor's office or it may be typed or printed on an Additional Attachment Form (TD-420-732). 45134 . 2306 Manufactured home will be X AFFIXED REMOVED El 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.certi that the manufactured home has been affixed to the real property as described, or a building BLDG PERMIT# per it h s been i d for this purpose and the attachment will be inspected upon completion. (1/46/19l �8 NA SIGNATURE/TITLE SPOKANE COUNTY BLDG PER IT FFICE/PHONE U D Y�`'^ X DIVISION OF BUILDING AND PLANNING MPIE1,0 25 H l OWNER INFORMATION' �J / /EES PEES COU # INC UNINC s REGISTERED OWNERS #LEGAL OWNERS Provide the Washington Driver's License or I.D. FILING FEE I )4 2 1 card number(PIC)for each owner: NAME OF FIRST OWNER 62.6tL 0„/20M APPLICATION R E Frank D. Gibler 6Ze,[Efcd60 G NAME OF SECOND OWNER MOBILE HOME FEES T• Oleta A. Gibler E ADDRESSOFOWNER ELIMINATION R 304 N. Shamrock Street E --OR--if the owner is a business, L- D CITY STATE' ZIP CODE provide the Unified Business USE TAX Identifier(UBI),found on the Veradale WA 99037 business Registration&Licenses I NAME OF FIRST LEGAL OWNER' Document. SUB-AGENT FEES I Washington Mutual Bank P. MAILING ADDRESS OF FIRST LEGAL OWNER More than two owners or one TOTAL FEES &TAX N H 1201 Third Avenue lienholder? Please use attachment Q L CITY STATE ZIP CODE form(s) #TD-420-732. E Seattle WA 981 01 DEALER'S REPORT OF SALE R 'SIGNATURE OF LEGAL OWNE CATES CO - !NATIO, s TITLE/REMOVAL --it '�' 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 mate al 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/. ' onment /(-7< r G:f, $q 7 '7 ? '� 1 b'f' (RCWTHAT 46.12.210). I DO SOLEMNLY ATTEST UNDER • `'�* W DEALER NAME �/ 1/ TAX JURISDICTION/TAx RATE THATUWEARE THE REGISTERED OWNERS OFTHI 04,6 -• TION I CCURA`TF� ajner ' ture(s)&Title(s): ,,,�..• -s>,,, Womach ' s Home Sales , f►3C. `b A /p( *;�41 �'` DEALER'S AUTHORIZED SIGNATURE /� / t 01 .► l �l ��Az /i1 / t ....y„� ) � t2 , V -. ,Rz ll P 0c S, X ��� yam`) USE TAX EXEMPT Sale to a Certified Tribal member on X ?���u�C the reservation (attach notarized statement of delivery) NOTARY OR CENSE A ENT&NUMBER . '-; :• • t.!^ i,(1,N ORN BEFORE ME THIS Residing in(County) x A X' ,S JAI., ��% 1• N1 �� 00"S' F 19 9 2n Jl-<l�.y�.� 6 COW( LICE SING OFFTiS6 L:(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. NAME SIGNATURE OFFICENFS OPERATOR NUMBER DATE X TD-420-729 MANUF HOME APPL(R/2/94)M Page 1 of 2 ARMSTRONG ESTATES S5 GRASS SOD BLOCK 2 GUTTER FLOW UNE PLAN DIMENSIONS SWALE"2 TggC AT�OWEST , LOT 6 INLET + 0.2 3 0.5' 208 SWALE SECTION W/O DRYWELL NOT TO SCALE 20.1'x28' DRAINAGE EASEMENT 1"=30' 2.10'--0.- 20.1' CURB INLET 2, .;. .l 18' RT. STA. 14+88.05 =1 I (SHAMROCK ST.) I ' 1 I.E. 2024.80 L=3.5' 1 l 90.00' /d G o *t..4 3 22'x22' DRAINAGE SW LE • h BTM ELEV. 2024.47 0 2 in _M I iSE- 30' BUILDING SETBACK v .-.�. — 2025 so rn C° o 6 ro 16.1'x46' DRAINAGE ao - 25' EASEMENT _ ROW r _ 3' 1 16-1 L CURB INLET-----___________.4I;. 18;.' n I 18' RT. STA. 13+73.27 ` - 1`- 18'x40' DRAINAGE SWALE /- (SHAMROCK ST.) L 13.4' - BTM ELEV. 2022.23 I.E. 2023.38 f- L=2.5' W V. ::1 ,-us '1Ius 30' BUILDING SETBACK W 9: � 70.25' \. .: 6-4 63.72'I- 63.72' V) Y 2.10'- NIXON AVE. U 1D O c - 11 I - CURB INLET M1 18' RT. STA. 10+42 0.011*♦ 11 Q I. (NIXON AVE.) �•� � M� wAsrr� •4� = I.E. 2022.56 1�*�\'��°F H�r� � , (n L=4.0' ♦ y,`c • �'i�. IIII . mr. is-0_,0 , ,: -81 Taylor Engineering, Inc. 11:4, 27616 4`"• O Civil Design and Land Planning �• SS• �OISTEaE(4)A•.� (509) 328-3371 •ir�iAi•��y-r��y I FYPIRFC 11R/73/Q4 I r ; PROJECT NUMBER= 95010498 APPLICATION Y DATE= 12/20/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 304 N SHAMROCK ST PARCEL#= 45134 .2318 ADDRESS= VERADALE WA 99037 PERMIT USE= NEW TRIPLE WIDE MANUFACTURED HOME W/GARAGE PLAT#= 005236 PLAT NAME= ARMSTRONG ESTATES BLOCK= 2 LOT= 6 ZONE= UR-3.5 DIST#= F AREA= 00012218 F/A= F WIDTH= 90 DEPTH= 136 R/W= 50 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = VERA OWNER= GIBLER, FRANK D PHONE= 509 926 5874 STREET= 15910 E 11TH AVE ADDRESS= VERADALE WA 99037 CONTACT NAME= FRANK GIBLER PHONE NUMBER= 509 926 5874 BUILDING SETBACKS: FRONT= 30 LEFT= 30 RIGHT= 15 REAR= 10 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING PLAN REVIEW REQUIRED Ce---e-4}/ COMMENTS: 4j.0 ! -_ - BUILDING SETBACK REVIEW REQUIRED i `1 COMMENTS: IQ-- d-6 - ENGINEER APPROACH/ DRAINAGE/ FLOOD q, fA1/4 jc-/ ` kc- Or COMMENTS: HEALTHDIST NEW OR ADDITIONAL WASTE WATER () 1_, lAdikthit, COMMENTS: ' / q ******************************* BUILDING PERMIT ******************************* CONTRACTOR= OWNER PHONE= NEW= X REMODEL= ADDITION= CHANGE OF USE= DWELL UNITS= OCCUP. LD= BLDG HGT= 8 STORIES= 1 BLDG W X D = 24 X 36 SQ FT= 864 SPRINKLER= N REQ PARKING= #HANDICAP= CRITICAL MAT= N PROJECT NUMBER= 95010498 APPLICATION DATE= 12/20/95 PAGE= 02 DESCRIPTION GROUP TYPE SQ FT VALUATION GARAGE U-1 VN 864 10368.00 ITEM DESCRIPTION QUANTITY FEE AMOUNT RESIDENTIAL VALUATION Y 126.00 ****************************** MOBILE HOME PERMIT ***************************** CONTRACTOR= OWNER PHONE= YR/MAKE= 1995 SILVERCREST MODEL= 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 31.50 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING BUILDING PERMIT 126.00 .00 126.00 MANUFACTURED HM 186.00 .00 186.00 312.00 .00 312.00 JO 0 :.e_ PROCESSED BY: JULIE SHATTO 3`x1.Ob PRINTED BY: JULIE SHATTO ******************************** THANK YOU ************************************ APPLICATION INFORMATION hat is the JOB SITE address? ASSESSOR'S tax parcel number? N/ 3 S"747//7---o/z69 (.< Legal description as it appegrs on the property deed 7-teeo n,5 6,r- 2 7`0 S OWNER or OCCUPANT Phone 71l< 91- 70 7z-7 Mailing address City,state Zip / 1= ) ( 1k (>1;2 D Lw— wn Who should we contact regarding this project? Phone F4z/mak l'/BLF2. g� 6, 5-- 577 What work is being done under this permit? Lone R Inspector dlstnct Property size RIght of;way width y Q) Water district »> a d B'uildin Building height / #of stories Contractor bimensions TOTAL SQUARE FOOTAGE a� x 3L 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 Width: .,. (( / Length: m' What is the square footage of How high is the sign? 3 9 /(j --0c ( the sign face? Year: Make: l/L-U '2C7" • Installer 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 Fusel Storage Ten'ks Swimmin 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. 137 6 5GN ✓i� 5 QFT 5 ADDRESS: ZONE:: ROAD WIDTH. v. FRONT• ='` FLANKING. COMMENTS. REVIEWED 8Y --- ' Y--