1992, 03-06 Permit 92001330 MHSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 B ORQ)MAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/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 orcanceLtirprovibnsofany state �J claw regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction
SIGNATURE OF �� fj j� �, APPLICATION
OWNER OR AGENT L4. �`4—"C \ �"�" "''f� DATE
PROJECT NUMBER= 92004330
� (‘ 4jat,clli4 v�
ISSUED PERMIT DATE= 03/06/92 PAGE= 0i
**************************** PERMIT INFORMATION ****************************
SITE STREET= 11920 E MANSFIELD AVE 4006 PARCELw= 09544-6007M
ADDRESS SPOKANE WA 99206
PERMIT USE= SINGLE WIDE MANUFACTUREI) HOME
PL.AT4= MH0045 PLAT NAME= PINECROFT MOBILE HOME PARK
BL..00K= LOT= 6 ZONE= UJR-7 DIST-= E
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
w OF BLDGS= 4 DWELLINGS= WATER DIST =
OWNER= BERG, ROLLAND PHONE=
STREET= ii920 E MANSFIEL.D AVE 4006
ADDRESS= SPOKANE WA 99206
CONTACT NAME= ROLLAND BERG PHONE NUMBER=
BUILDING SETBACKS: FRONT= 4 LEFT= 5 RIGHT= 5 REAR 5
****************************** MOBILE: HOME PERMIT **************************
CONTRACTOR= OWNER
YR/MAKE= 1976 NASHUA
SERIAL=
ITEM DESCRIPTION
PHONE ==
MODEL=
WIDTH= 12 LENGTH= 40 HEIGHT= 10
QUANTITY FEE AMOUNT
INSPECTION FEE i 50.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 9.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
03/06/92 i508 63.50
TOTAL DUE= .00 TOTAL PAID= 63.50
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MOBILE HOME PMT 63.50 63.50 .00
63,50 63.50 .00
PROCESSED BY: FORRY, JEFF
PRINTED BY: FORRY, JEFF
******************************** THANK YOU*******************************x•*