1990, 08-02 Permit App: 90003708 Mobile HomeAUG -02—'90 12:17 ID:HEALTH SPO TEL NO:4564716
+.m=..rr NUG -02-' aiii3�1
ID:BLDG AND SAFETY—SPO TEL NO:509-4S6-4703
SPOKAN COUNTY DEPARTMENT OF BUILDING AND SAFETY
w. 1303 9ROADWAY AVENUE
SPOKANE, WASHINGTON 0928O
(600)488.387b
anon, stats that the Information c=ontained in it and submitted by me or my agent to compile said permit/application Itl true
to proceed with processing. In addition, 1 have read and undefatend the INSPECTION REOUIREMENTS1t3fY CE
Iyy With Sarna. All proVIaiOns of IaWS pnd ordinances governing this type of work wIII be complied with whether Specified
f this permit/epplICatioh and any sutreequant inspection approvals of Certificates of Occupancy shall not be construed to
a Of any state or local law regulating construction. ores a warranty Of contormanCe with the provisions of any state or local
APPLJCATIOfd
DATE
learnt,/ that 1 haVeexatnined this permit/appl
and correct, and authorise Spokane count
provisions Included herein and agree to corn
herein or not. 1 understand that the Iasuanoa
give authority tovloiateorcancel the provlsio
Weis revisiting construction.
1StlatyATtIRt: OF
OWNER On GENT
14263 P01
11926 P01
PROJECT NUMBER= 90••0'3700
4.04040w0c+•Wb(O(•0(•') M M ofat•Ow#Ow
`•i'ri: STREET= 41
ADDRESS= &R
F" I": F4 M :I: T USE= SI
00
PLATOm
ARE=A=_
U OF BL..ziGS=
OWNER m=
STREET=
ADDRESS=
PAGE= <t4
3. bt )+i )i- oE• of Ow o b{ a * A f ' J:' i...:I: (. * I •T• 7 (: J N 06 0( ib 04 i( f4 04 b4 a< )(i( )(Ow Ow 0w Ob bw 0w * x 06 0( 04 O4 •){, OL• O( O(• Ot• oe 46 bw O(•
N O I• B 3: N RD
I:':N ACRES WA 99()16
GLI:': t4EDI:i: mcmILE HOME
357 PLAT Nt MI:::m L,Fa'Th4R•1:N1�:. ' S�
4
LOT= =r' z (.) N E .
I;; ; • ty ::.. r. WIDTH
'JI' DWELLINGS 4
CL..::MI Ni'S•f .Jlii:tS
WA (a4 .,F ACRE.,99046
CONTACT i lAMI":nn ,.JIE.' •.S' C L..I Ml NT,S
BUILDING DING SE»'TBAt(:iKS : FRONT (:IN•r,:: E:;)<V'T' LEFT= !":X.`;• r
* 0 bb Ot• ){• a(* * a(• ac )raw aw P414 a( st• (x- - it )( 40 Ow Ow bw )(k)( P FE: V :I: IEi' Ld
DEPARTMENT RE :I' I:::W COMMENTS
PA!' C:FE;L.,'.t::R: 10553-0409
SOO
AG DIRT4=r;
122 DEPTH= 175 R/W:::: 40
f+h40NIE?'0 5()9 924 7334
1 !• (JNEI,.JM({tER ?4)9 924 7334
RIGHT= CYST kE':ARKP E::X:ST
INFORMATION *******4(•4**04wtrt<x)_)*xaiat•ka(•*r( .*
APPROVAL COMMENTS
BUILDING E E T B A" K REVIEW 1 E (+?(.J:LR D
14 E: A Jn,1 I f X) :1; £• T NEW W t )f.)I110Nr'! . W (1,S •r f: WATER
* N Od *.w Of O{• * 0(• 0{ 0{ of 3i ai* 91.0' di ii of i s i=: in* 04 K a( 3r h MOBILE HC Mf':.
CONTRACTOR= CJ NFI:
YR/MAI<E::=:=; 1977 NAS -40A MODEL=
WIDTH= 14 L..ENC4i'H-= 70 HEIGHT= 10
I 11111
--r5c ons ( 0 aV
I'E:RM:ET*4•)w4*beb[O('**040040(4('0(itviOc0 0i4b(••H•bih
PHONE=
SERI Al_4t=na
:I:TT:t'f DEE'.(::R:EI::''rT:(:1N
1 4SI'ECT., ON
(N....iAtib:EFF,.,.,,.
PERMIT TYPE FEF AMOUNT
MOBILE HOME f'
1111,11.1
PROCESSED BY: ,.ICJa•4
PRINTED BY :• ,.lOH
f$. ii e0(•*0(•OwOGOL•Obd(•*).•) OI•**
62.50
62.50
QUANTITY
1
i M(:)UN1 PAID
.00
.00
FEE AMOUNT
'10.00
A.A5t)
00
AMOUNT OWING
62.50
62.50
L, AR:;' CJ N
LARSON
* a(* a(• at• W10 b(• 0(• )( 4-X ac• THANK Y O t.J )e • )t )i aw bt be �e x * * •x a, * * 94 9Q 4e as * * x. •x• be )t aw ;'e• * 441w
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
1 certify that I have examined this perm it/application, state that the information 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, 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= 90003700
3)33t• a' * X ai * aE an C tt * ai- ai- ai of at ai * )i• ai- ai• ae ai * ii• ai *
SITE ETREET=
ADD f:::s =
PERMIT USE=
PLATO=
rARE:rA=
0F' Dl...D(:;::::
OWNER=
ADDRESS=
DgAA APPLICATION 4-j _r{ 0�2 / 9i':; ::,�yi-.:.
APPLICATION *JMt r
haE ) 8 ac aE E ak laahl aaa)E Y k Paaa
415 N C;ORB]:N RD
GREEN ACRES IE WA 9901 6
:i:N(:;LE WIDE: MOBILE HOME
001357 PLAT NAME::::
i LOT=
!:- :r:a:.
415 tJ (:' (:) E't X t :1: N RD
GREEN ACRES WA 99016
PARCELO= 18553-0409
!<sATHR:I:Nt•E:' S .k i_ B
9 WIDTH= 122
DEPTH= 175 R/W= 40
PHONE= 509
09 924t 7334
CONTACT IMF= .. E s CLEMENT ' PHONE NUMBER= r>L:)9 924 7334
BUILDING ,S':::TBr•ACi<,`:i : FRONT= EX T' LEFT= EX`s'r RIGHT= i::::xsT REAR= i:: z;. 'T-.
'ii' -H. * * a+. 'P. * a1. ak N:.:p:* a(...I•: aC al ai• ai' ak * a+. •» ai• a:. P: 'P' at• . af. REVIEW INFORMATION •,:................• ai. 'P' 'P. 9i' .•. * * * 'A. ai• * a+. b:- *
DEPARTMENT REVIEW COMMENTS T r'
APPROVAL COMMENTS
BUILDING SETBACK REVIEW REQUIRED
hil:::fAi...TFII):i:sr NEW OR ADDITIONAL
]:f '. A1...
a+. ri * .» .) a,. * a .. ai af. at * .. # ai- ai . ai- ar ii• aE aE ai- a{ of ai vi' •i+: a6
CONTRACTOR= :::: C)WNEEi
YR/MAKE= 1977 + NASEHU(
:ETE:ii DESCRIPTION
INSPECTION T':f.(:)N FEi:::
STATE EURCHARGE
[:;(:)t.JNTY ?;t-1RCHARc,E:
PERMIT TYPE
MOBILE i-i(:)P-1F: PMT
•1.T.
WA.....E: WATER
MOBILE HOME PERMIT ai• Jt al- at' ai' at !t Jt- --)i- Ji ak ai' at li- li' at' ak !t aY ai- a1' a1' at ai- •j R- *
PHONE=
MODEL=
Wa:I)TH-:: 14 LENGTH= f) HEIGHT= 10
FEE: AMOUNT
62.50
6.:7.50
QUANTITY FEE AMOUNT
1 5:0..00
4.50
0.00
AMOUNT PAID
..l)0
.00
AMOUNT OWING
62.50
62.50
E:'E•tc:i(E::r:='i:1i BY: ..1(:)!-dj4 LAR (:)N
F'i' :i:NTEi:I:j BY: ..1C)E•!N LARSON
-ji-'ji * a+. ai * ai' ar::ni ai• as ,' ->. ai •». *........ a+. * •N• a+..pi ...n......h. •x THANK - .. .
i••i rl PJ K Y C) i.J -x- a.. ai• a.. N. ar �n: a+. a+. n..,,..,i..x a.. ai- ai- a.. ii- n> * ar a+. ai• ar ac- a:. a.. a„-;i..x. ;,. * ai•
ALG -02-'90 12:04 ID:HEALTH SPO
TEL NO:4564716
#262 P02
, '`.r.%!SPOKANE COUNTY -HEALTI-I :.DEPARTMENT
PERMIT NO.
i'.O.PLOEGER,M.D. ,M. P.H. . Hea,]th O(ficer.`
Division of Sanitation Aly
$10 Jefferson Street `
Sp'bkane, Washington 99Q1 DAT
40/7e/
No A018
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL F ILITIESP one
l �J J R�
Name Zejt_e - e)` �"`1i2 Address l_ C
Address of Proposed Site 77- 4'/...,-S›.-".. - —e—TA—r/
Type of lis!?' -1'=1,-) '4) hL'- Is basement for building armed') .G
Number of Bedr.oms e. ---1.7.=r; -Roilding Capacity Camp Capacity "-). Other
Water- Supply (- .-v`I-+'L, - -42"Q' Chi Weds( i I ). Drywel1 -"I?f,\
Septic tank capacity 7--5 n gals. Style of tank
Length of disposal field---.—.-4-SQ / Absorption Pits
leach Bed
(1) Show relative location of: Proposed house. septic tank. I I
disposal field, well. 9tcsa9e and ether cut buildings. ;� t
C-% 1, t
(2) Moke note of any heavy slope or swampy a�.e 3'.t r4;anpe„ (: /
•
t> } ,- tr:1 1' 4:
rte' •G J V — .��-
����a �1 I0, i
Installer
4IIE' SPP ON
SDN -c0 S pty
�� O �H�� ka'ckc.
c.
�H MAP KpEe `�� OF
S��S �o� 4OGp,'C
Final Inspection Date
Remarks;
Y } [-' µ t
n r , 1
7c I, 1`12
CONTRACTOR _Irei/'-z -� �/ f
?ORM sea RE .Nekl.TN
For Spokane County Health Department
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS:
CITY/STATE/ZIP:
402(
SUBDIVISION:
BLOCK: / LOT:
LOT AREA:
# OF BUILDINGS:
OWNER: ,_
/967
7
ZONE: /%lam DISTRICT:
F/A: WIDTH: j407p7 DEPTH: 2_ R/W:
OF DWELLINGS: / WATER DISTRICT:
PHONE: 2 7
MAILIN' DRESS:
CITY/STATE/ZIP:
CONTACT:
SETBACKS: - FRONT:FR�
PERMIT USE: 77��il`'�, ""L'—T.-
PHONE:
LEFT:
RIGHT: REAR:
/c7- 20'
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
PHONE:
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: