1987, 09-25 Permit App: 87003195 MH SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
NORTH 811 JEFFERSON
,SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct.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 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
OWNER OR AGENT DATE
PROJECT NUMBER= 8700%195 DATE= 09/25/87 PAGE= 01
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GREENACEE WA
'• 99016 901
PERMIT USE= DOUBLE W. c:. MOBILE jti . ' : I " : t . N
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tA , . 000078 PLAT NF "i _ APPLE „; 1 . iS C:;;'EETATEE 2ND ADD,.
BLOCK= LOT= .10 ZONE= j.,'M(..j DIET4=
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AREA=RI::.i•:;:::: s.)!`J,_I1.i t:000 ( ;/A:::: I w1:c:1t..1.f..�:::: 93 DEPTH,. `i :::: R. j;;l::. 50
::11.•!il''i#:::f•.,:::: t;;::;'•NE:. : I•; BARBARA PHONE= 509 928 6072
ETREET= 17405 E 6TH AVE
ADDREE .. 6HLENACRES WA 99016
CONTACT i ;.p}C '1' Nj'aI``1E:::: OWNER PHONE NUMBER— !:509....=7! ` : ....6:t7.:
BUILDING :.Y:... ....! E•::.; FRONT= LEFT= RIGHT= .:.E='±:.
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DATE
DEPARTMENT NAME REVIEW cc::''s''!i''1::.!' ' ,.. TN/OUT !.'i'•..I. . ...i•:;I...,..
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* INFORMATION WORKSHEET *
* *
* PARCEL NUMBER: 19 ;5-2 ( 8 ) C *
* STREET ADDRESS: *
* *
* CITY/STATE/ZIP: *
* SUBDIVISION: Wig 0,60, y T- J 4
*
* BLOCK: 3 LOT: IV ZONE: ('I1 /4 DISTRICT:
* LOT AREA: F/A: WIDTH: 9 3 DEPTH: f2 3 R/W: 9
* f *
* # OF BUILDINGS: # OF DWELLINGS: *
* ,,pp / *
* OWNER: ` 4,&9 ,/0A//V 13077:41g'HONE:�a2S- lD�}/
* MAILING ADDRESS: /7 4) / �JiC cp� *
(klee56-4_)/ e4/47.45S //�� //
CITY/STATE/ZIP: �,.�al • `�90�� *
*
* CONTACT: PHONE: - *
-
* *
*
SETBACKS - FRONT: LEFT: RIGHT: REAR: *
* PERMIT USE: 4e rl 061 cif (-I-6)11 E g8 Pri)Wie *
*
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* BUILDING INFORMATION *
* *
* *
* CONTRACTOR LICENSE NO. : . *
* *
* CONTRACTOR: PHONE - - *
* *
* MAILING ADDRESS: *
* *
* ARCHITECT/ENGINEER: PHONE: - - *
* *
* MAILING ADDRESS: *
* *
* NEW: REMODEL: ADDITION: CHANGE OF USE: *
* *
* DWELL UNITS: OCCUPANT .LOAD: BUILDING HGT: STORIES: *
* *
* BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. *
* *
*REGUIRED PARKING: # HANDICAP: SEWER:(Y/N): HYDRANT: *
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JIM OR JACK WIRTH
S. TSCHIRLEY RD. - 926-1140
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GREENACRES, WA. 99016
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