1984, 01-03 Permit App: 84A-005 Set Mobile HomePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDkJG &.SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. N. 421 Corbin Road
2.
LOT BLOCK
7 1
OWNER
3 Gregory Goodell
MAILING ADDRESS
N. 421 Corbin Road
CONTRACTOR
Northwest Mobile Homes,Inc.
ADDRESS
SUBDIVISION
Kathrine's Subdivision
PHONE
924-4759
PHONE
PARCEL NO. r n
- (3407
LEGAL DESCRIPTION: Lot 7 in ;lock 1 of
Kathrine's Subdivision, recorded in Volume 4
of Plats, page 78
ZIP
Greenacres
99016
4.
LICENSE EXPIRES
PHONE
535-2909
Actual Set Backs in Feet to:
North (South L
Size of Parcel
we%>c 17
East
ZonQlassA
IWest ! /
on
.Residential,3'
Commercial ❑
ZIP
Type Const I
Occupancy
i...._
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Spr'nklered
❑Yes DNo Req 'd.
Remode ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor Upper Floors
GaragelStorage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover ICover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF
WORK ❑ BLD. ❑ PLMB. ❑ MECH. M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No:
Received YesE Noy:.
Number
8. DESCRIBE WORK
Set 14X70 Mobile Home
Shorelines/Flood Haza d
Yes❑ NotApplic. ❑
Plans Requ'red ❑
Received 0
VALUATION
9.,,
SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER '
PUBLIC
PRI VAT 0
SEWAG
SEPTI
SEWER ❑
Ow /
Public ❑nershipPrivate i3
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE 12-01-83
SPECIAL APPROVALS SP CIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
Ai'1 t
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular)
MFG. Home
Other (Specify)
50.00
TOTAL $ 50'00
PERMIT NUMBER
&4A- 00 5
FILE COPY
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE-IS5UEdi
PERMIT NO. 5 5 *5 0.0 0 iCliAL
LScaEcoI
CORPORATION
❑I
GRAIN
STORAGE
BINS
BULK -FLO
TANKS
POTATO
VENTILATION
PIPE
qiL
IF
PRE -FAB
STEEL
BRIDGES
TRUCTURAL PLATE
BRIDGE FLOORING
(CISM
SECTIONAL PLATE
PIPE ANO ARCHES
1 TO
TRUCK
FO L)1 r'ML NT
AMERICAN AGRI-PRODUCTS DIVISION DATE.
SPOKANE CULVERT DIVISIEJN
SCAFCO - PACIFIC TRUC
EQUIPMENT DIVISION
$O'