1984, 07-12 Permit 00001155 MHSIGNATURE OF
OWNER OR AGENT
4 1214 a:
JOB ADDRESS:
11920 E MANSF]:ELD AV28
OWNER:
SHERR ILL) KENNETH A
ADDRESS:
6410 N LYNDEN RD
TY. ST: Z iP:
OTIS ORCHARDS WA 99027-0000
APPLICANT:
SHERRILL, KENNE:TH A
CONTRACTOR:
ADDRESS:
CITY: ST: ZIP:
PH: LICENSE*:
ARCH/ENGINEER:
ADDRESS:
CITY: 5T. ZIP:
PARCELS:
095440421
'CENSUS TR:
(INSPECTOR:
PLAT*.
000000
!LOT 8c BLOCK 'FINAL
028 000
PLAT NAME:
PINECROFT MOB]:LE HOME: PARK
ZONER:
ZONE IFSB
IS-1 IS-2
r
IRSB
!MOD
USE OF PERMIT:
SINGLE WIDE MOBILE HOME
ADDRESS:JOB
11920E MANSFIELD 6Wan
M 0 B I L. E:
M/H PLACEMENT
Site
Number 1 W 14 I... 56 H 10
APPLICATION
DATE x
7
SEC, S:
0001177
DATE: PROJ*:
07/12/84 00001155
Mobile Home Inc t:a] ] atjo $5n 00
.
FEES:
$50.00
'PAID BY:
CA
C ICG 'NC
COUNTER APR: PLANS EXAM:
DATE:
07/12./84
I -I () M I.'.
PERMIT
Zip —00000
TO'T'AL. FEL::S $50 . 0 0
OFFICE COPY
07-13-84
5539z *>0,n0