1990, 08-21 Permit App: 90004078 MH SPOKANE COUNTY DEPA1 T T OF BUILDING AND SAFETY
W. 1303 13FierrAritY AVENUE
SPOKANE,WASHINGTON 99260
`1,509)456-3675
I certify that I have examined this permit/application,state that the informatio 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 APPLICATION
OWNER OR AGENT DATE
:'ROjE:f::T NUMBER= 90004070 DATE:_ 08/21 /90 - 1::'A1.;1:.::: 01
APPLICATION
********** *********** *K*:**** ;;F F''I...f I..:t:i i .I.1.1 f11 0**********.*** ******************
SITE STREET= 7202 F: 10TH AVE I::: t!•;i.:EL.. 245 t
ADDRESS= SPOKANE WA 99212
PERMIT USE= SINGLE WIDE MOBILE HOME
PLAT4= 002955 PLAT NAME..::_ W000L.AWN PARK
:'I...0CK.== i0 I...0T-: ) 70NE= A1';4'1.Jk; DIST4=
AREA=:: 00000k'O0 1- /A:r.: F ' WIDTH= 4 00 I)1-1-'"riI:::: 120 b /W= 45
: OF BL_nfrs::r. 1 n DWELLINGS= .1
OWFiE::R::::. 'v:r iNGO , A. C. PHONE= 509 920 4567 r
STREET= 9407 I' 1 2TH AVE
ADDRESS= SPOKANE WA 99206 .,
CONTACT NAME A. C. VINGO PHONE NUMBER= 09 920 4507
BUILDING SETBACKS : FRONT:.- 32 LEFT= 31 RIGHT= S REAR= 25
N:a{ ii*** :**.*..if•**•*•#*•**••n:***•*•*•*hi*•** REVIEW INFORMATION ***********K*********:k***
DEPARTMENT REVIEW COMMENTS APPROVAL ;..:i It it l NT l;
•
BUILDING SETBACK REVIEW REQUIRED
._ ..� . .. ...°Za--
I•IE:`Ai...THp:r.ST NEW OR ADDITIONAL WASTE WATER
................................_.........._.............._.........
;:*•x**}t.. *•**ii•*•}e**.y;.*.....H.};•*•*k*•''*u.:„..*3' Mf:IBIL1.= HOME PERMIT * 3 ' *************
c::ONTRAC::TOF ::: OWNER PHONE=
YR/MAKE= MODEL..::::
SE:.RTX11...4--.. WIDTH= 14 I...E.NG. IH'- 60 HEIGHT= 10
ITEM DESCRIPTION QUANTITY FEE AMOUNT
• INSPECTION FEE
STt'iIF SURCHARGE Y 4 .. k 0
COUNTY SURCHARGE Y 040
PERMIT TYPE FEE AMOUNT AMOUNT” I''A1:1) AMOUNT OWING
MOBILE:: HOME PMT 62.50 ,00 62..90
62.50 , O0 62,50
PROCESSED BY : JOHN i...f i ,`i(:1N
PRINTED BY : .JOHN LAR S ON
:?••k•****•*}i•}k*•*•*•,t*•h:*•*••iii}i*•*•it•#*•k•R•ii:•.i'*:}f*•*• THANK Y 1:1 I I •h::.:.p:••*•*}i•n:•Yt*}f*•*.•h:?4*•hi}t}i}k' •..*.**.N:...... ...
AUG-21- 9 12:28 ID:HEALTH SPO TEL NO:4564716 #370 P01
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tiLIG—21- "90 10:53 :ID:BLDG AND SAFETY—SPO TEL r :509-456-470:3 14969 P01
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SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1308 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509) 456-3675
iaertifyfhallhave oxarninedthig rmlt/applloallon,statethattheinformationcontalnadinitandeubtoittedbymeotrnyapenitoCompile$aidp arm,t/appplioalJzA.firuC
end cOrtoct.and authorize Spokane County to proceed with proceaeinp, In addition, I have reed end underetarta the INSPECTION RFQUIREMENTSJivOTtC.
proviaiona Included he"air and agr40 tot complyy with same•All provlsione of laws and ordinances ggawrning 1hi0 typpo of work wtli be catnplled with whether apecln d
tera nor not,tuhdaratanathatthei euenct(oflhiepermit/appliCptionanderyauieepuentinepect`onapprovalsorCartificateeofOrcupemC' h*flnothpoongtruedto
ar/othe rle:1y so viciate Grcancel1ruotlon. th•proviSipna otany Mato or 1001 law regurating conatruotion,oras I warranty of conformance with theprovtslont*of anyatateor local
laws r9aUtir ccr
SIGNA7O3E OF
APPLICATION
OWNER OR AGENT — r,.,. ----�— DATE
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Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, 'WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: .;y<37 4 yd - S'" ?
STREET
STREET ADDRESS: 72-6)
CITY/STATE/ZIP: Vg-; e uja,s-X , 9 2
SUBDIVISION: l/(/ 0 0 al/AY° n car
BLOCK: /) LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: �a v y n '' d PHONE: - -
V
MAILING ADDRESS: 9 l 0 „�- / 2_7
CITY/STATE/ZIP: cfa2O '677 t Gd-1,, '32()
CONTACT: PHONE: i O) -92 - s-G
SETBACKS: - FRONT:
3r� LEFT: j i RIGHT: .,..5- REAR: 0,46-
PERMIT USE: /f- G�
****************************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
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. :
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
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