1992, 12-22 Permit 92011110 MH-VoidSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY 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 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. Q
OWSIGNATUREERAG Q / / �• �. Q APPLICATION �Z/a�/7,
OWNER OR AGENT �/'� •• �• -4 ✓ /�+�-�c�`. DATE
VOID
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PERMIT INFORMATION
.... ........ ... _ ......
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SITE STREET= , 'i :r . 4e ... MANSFIELD AVE 0022 PARCELO= 45094.6023M
ADDRESS= SPOKANE WA 99206
PE::RMIT USE= SINGLE.: WIDE MOBILE: HOME
PLATO= Ki E'iOcl''}5 PLAT NAME== "r'INECROFT MOBILE. HOME. PARK
iiit_Ol,lt:::: t..C)i== ,:.GIBE-- til't--r L17.S7*:= !-i
AREA== 00h0k0003 F/A== A WIDTH= DE TH:
OF I LDGS== f 0 DWELLINGS= i WATER DIST wwrm
--
OWNE:i<=:: F';rii`iKi=i..., CLAUDIA PHONE= :iC)Y 11920 0022
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STREET= EtF�S=IEfIAVE
ADDRESS= SPOKANE WA 99206
CON'T'ACT NAPE=:: CLAUDIA HANKiii:l... PHONE Ni.)i•f13FR— °'1%
..,t�, 926 779S
BUILDING SETBACKS: FRONT= 4 LEFT= 5 RIGHT=:: 5 iZFr`R= 5
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MOBILE HOME EECMIY ........
CONTRACTOR= OWNER PHONE=::
YR/MAKE:- 1992 CHAMPION MODEL=: SEQUOIA
SL-_RTAL..O:= WIDTH= 14 L..E.NGTH:=. 70 HEIGHT= 00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------ -------- _...._....................---
INSPECTION FEE:: 50.00
STATE TE. SURCHAitisE. Y 4. _1.
COUNTY SURCHARGE 'r' 9<00
PAYMENT _...
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PAYMENT DATE. REfCEEIP o: ME
r'
i -1 i I I G. tY i (`i i"I t. I j j'v (.
12!221'92 743`F 63:.50
TOTAL DUE= .00 TOTAL PAID= 63.?_
PERMIT TYPE_ EEE AMOUNT AMOUNT ( PA D FPNUN ,, nl.i NC.
...` ................_.......---_.._.._._.— ------------- ------------ ....__................._.__-................
MOBILE HOME Pill' 63.50 63.50 "
63.50 63.50 MO
PROCESSED BY: .JUi...a:E SHATIO
PRINTED BY: JUi...:I:E: SHATTO
THANK ,
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