1987, 02-02 Permit App 87000235 MHSP8KANE COUNTY DEPARTMENT OFBUILDING AND SAFETY
NORTH W11JEFFERSON
Sp0KAmE.WASH|NGTON9g26V
(509)456'3075
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APPLICATION
SIGNATURE OF "^-rc
------`~~—
u�m�nun*uo`. PAGE= Oi
DATE= 02/02/87
--------------------------------- APPLICATION ------------------------------
PROJECT NUMBER= 87000235 PARCEL NUMBER= 12544-0i3O
PERMIT U%E= DOUBLE WIDE MOBILE HOME
SITE %TREET= i703 N FLORA RD
ADDREJ%= GREENACRE% WA 990i6
PLATO= 999999 PLAT NAME= RANGE
BLOCK= 2 LOT= ZONE= AGRI DI%TO= �
AREA= OOOOOOOO F/A= F WIDTH= 80 DEPTH= 624 R/W= 60
0 OF BLDG%= 2 0 DWELLING%= i
OWNER- CHANDLER, WILLIAM PHONE::::
%TREET= 1625 N FLORA RD
ADDRE%%= GREENACRE% WA 990i6
CONTACT NAME= CHANDLER, CARY M. PHONE NUMBER= 509-926-7075
BUILDING SETBACKS: FRONT=
DEPARTMENT NAME
^/COUNTY ENGINEER
KnU 1M41'.
55 LEFT= 5 RIGHT=
24 REAR=
-------- REVIEW INFORMATION --------------------------
DATE INIT
IN/OUT IN/OUT
REVIEW COMMENTS
DRAINAGE PLAN REQ'D W/IN A%A
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COUNTY ROAD APP�OACH
ENVIRONMENTAL HEALTH NEW OR ADDITIONAL WASTE WATER
ENVIRONMENTAL HEALTH INCREASE IN LOT COVERAGE
COUNTY UTILITIES
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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 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. The granting of a permit does not presume to give authority
to violate or cancel the provisions of any state or local law regulating construction or the performance of construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT N 'v B.. t.... 87000235 .. . E• l•.I. (i BI;"1'; = 1 2 .c S4 4 0 ! .. ..
SITE STREET,.., 1703 N FLORA R:l
ADDRI: SS•= I.: �RI:::i:::i'•aAt'Rl::: > WA
rONTR L_:[c := OWNER
CON RAr TOR= OWNER
FIRM RM NAME:::: OWNER
ARCH, I::.i'.JG=
r REF:. T--
99016
MOBILE HOME PERMIT
F:` I" I r:, i` E =
PREVIOUS ADDRESS:
PARCEL 0=
STREET- EE 12607 I::: S RAGUE ri , I:::
ADDRESSADDRESS= SPOKANE W':( 99216
Y I:: ,f M (1 I : E = 1979 BUDDY M (:7 :t? I::: I._'=
SERIAL:a=: { 49(.....02"r'?(1.r'1:•M WIDTH:::: 64 LENGTH= 24 HEIGHT= • t'i
ITEM DESCRIPTION
:1:ON
INSPECTION CTa:ON FEE
BUILDING SURCHARGE
PERMIT I::I:::I:::S
MEASURE QUANTITY I= I:- E AMOUNT
SECTIONS ;y 100,00
`( OR BI...i°iNit Y 1.50
0
,1 101.50
(:tM'•r' PAID= .00
.. ... .
•jt• ??' 1E 1F :;E fi ih 9k it i4. 9C •Pi 'Pi •j$ ?C :�C •jh ;i�• :fit •ji� _iE •1G i�t in; :�t 9i• iE I::. N y..l Q L. I"'. I::. I""` 0R! ;ii• .ji..}(..yt :;r 3:. ioG ;;(:;L ** y(. .fi.jG •1F ;!f * ;1` * 3} 4 ;m
TAX SEGREGATION APPLICATION FORM
(Applicable to the division of one or more parcels of real property into
two or more parcels under different ownerships, also applies to
aggregation oparcels.)
NAME
ADDRESS / 7 71. ��4- i/Ze.e/h
PHONE NUMBER g072 - 702.5 DATE �/ /g7 } 9 0
DELINQUENT / 7 �d- ct/� — /`5 v
TAXES PARCEL NO(S)
I. Enter legal descriptions of all portions to be segregated. Also
include legal description of portions remaining (use supplemental
sheet if needed).
II. Make drawing of entire property. Indicate approximate dimensions
of all property lines. Indicate on which portions of property any
buildings should remain. If a copy of a survey is available, please
attach to this form.
III. This application is to be completed in its entirety before processing.
NOTE: The approval of this application by the County Assessor or his
appointee shall not be construed as authorizing the division of lands for
the purposes of sale or subdivision in violation of RCW 58.17 (Plat and
Subdivision Act). The taxpayer is hereby advised that no segregation
ill take/ce until this m 's complet
Applicant Signature
THIS AREA FOR USE BY APPLICANT FOR LEGAL
DESCRIPTIONS AND DRAWINGS. USE REVERSE SIDE IF
NEEDED.
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******************************************************************************
*************************'*****************************************************
* • INFCRMATION HCRKSHEET
******'************************************************************************
GENERAL INFORMATION *
*
*
*
4
*
PARCEL NUMBER:_ i O _yl3e
fOroat
STRT ADDRESS
CITY/STATE/ZIP:-�'rPf+�c',re_St�-
SUBDIVISICN:�=
BLOCK
LOT
LOT AREA:__F/A:
ZONE: Afie'
DISTRICT#:
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WIDTH: 136 DEPTH:_62S_
OF BLDGS: 2 # CF DWELLINGS:_
OWNER: `"'/ /,r t t_ (C�
R/W:__ __
PHONE:____ -____-
MAILING ADDRESS: (/2-( ( " '�'r�' 4a,
CITY/STATE/ZIP: 25 99/C
CONTACT:
PHCNE :___-____
*
*
*
*
* BUILDING INFORMATION *
* CONTR LIC!!: *
*
* CONTRACTOR: PHONE:__-_ - *
*
* FIRM NAME:
*
* ARCH/ENG: PHCNE:
* MAILING ADDRESS: *
* CITY/STATE/ZIP: *
* *
* NEW:REMODEL:__ ADDITION: CHANGE OF LSE:__ *`
* *
* DWELL UNITS:_OCCUPANT LOAD: BUILDING HGT:_ _ STORIES: *
* *
* BUILDING DIMENSIONS :___._-X____ (WIDTH X DEPTH) SQUARE FEET:
* REQUIRED PARKING: #HANCICAP:
*
*
SEWER IY/N1:_ HYDRANT IY/N): *
******************************************************************************
*********************************************************************4*-*** ***
* MOBILE ICME INFORMATION
* CONTR LIC#:__
*
* CONTRACTOR:_
* FIRM NAME: -7/5'
/e,o�
* PREVIOUS ACDRESS:�
* LOCATION: C-12E> PARCEL NUMBER: f 11-4/- - DIS.$)
* STREET:
* CITY/STATE/ZIP:______
MAKE: �2..+
*
*
PHONE: - -
/e.
*
*
*
*
MODEL: *
SER.IAL#: 641 ;-°‘2`/1 WIDTH LENGTF:6�
*
******************************************************************************
* RELCCATION INFORMATICN *
* CONTR LIC#: *
*
* CONTRACTOR: PHCNE:____-____-_____ *
* *
* FIRM NAME: *
*
* PREVIOUS ADDRESS:______._
* *
* LCCATION: PARCEL NUMBER:
*
* STREET:
* *
* CITY/STATE/ZIP:
*
******************************************************************************
* SIGN INFORMATION *
* CONTR LIC#: *
* *
* CONTRACTOR: PHCNE:
* FIRM NAME:
*
* SQUARE FOOTAGE:______POLE FEIGHT:
* *
* *
******************************************************************************
* DEMOLITION INFORMATION
* CONTR
*
* CONTRACTOR:
*
* FIRM NAME:
*
* BUILDING SQUARE FOOTAGE:
*
* NUMBER OF BUILCINGS:
PHONE: _ ____
* *
******************************************************************************
*****•****************** !************ a****************************************
PLUMBING INFORMATION
CONTR L IC#:__ *
CONTRACTOR: PHCNE:_____—_—__—____—
*
FIRM NAME:*
**************************************************************************
MECHANICAL INFCRNATICN *
0 CONTR L ICH:__ #
k PHCNE:—_---------
a CONTRACTOR: ------
* FIRM NAME:
*
* ELECTRIC:___ GAS: _ OIL:___ COAL:W000:_SOLAR:___ HEAT FUMP:__..
*
*
*
*
*************************************************************************** *
*********************************************************************************
MECHANICAL FEES PLUMBING FEES
ITEM DESCRIPTION
PROCESSING FEE
DUCTWORK SYSTEM
wOCCSTCVE/INSERT
GAS WATER HEATER
GAS HTG EQUIP<10C.000>BTU
GAS hTG EQUIP+100,000 BTU
GAS PIPING — 11 OF UNITS
HEATPUMP 1-100M BTU
HEATPUMP 101-500N BTU
HEATPUMP 501-1,000M BTU
HEATPUMP 1,001-1750M 8TU .
HEATPUMP +1,750M BTU
REFRIG 1-100M BTU
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1, 750M BTU
AIR CONDITIONER 0-3 HP
AIR CCNCITICNER 3-15 HP
AIR CONDITIONER 15-3C HP
AIR CCNOITICNER 30-50 HP
AIR CONDITIONER +50 HP
VENTILATING FANS
EVAPORATIVE COOLERS
HOODS
CLOTH -ES DRYER
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
AIR HANDLER 1-10000 CFM
AIR HANDLER 10000+ CFM
KLMBER CF
YES OR NG
ITEM DESCRIPTION
PROCESSING FEE
TOILETS
SINKS
SHOWERS
BATH TUBS
KITCHEN SINKS
DISH WASHERS
GARBAGE DISPCSAL
CLOTHES WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR DRAINS
FLOCK SINKS
BAR SINKS
ROOF CRAINS
LAWN SPRINKLER
SEWAGE EJECTOR
WATER SOFTENER
URNAL
DRINKING FOUNTIAN
NUMBER OF
YES OR NC
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