1984, 04-27 Permit 00000094 MH.1
IGNATURE OF
iWNER OR AGENT
A RIAl4b55E MANSE"IELD AV
M?. L.LY, JONATHAN 0
i°A 5L? 0 E MANSF I ELD AV
g'OKANE 3T: WA -P:992060000
ftUELY, JONATHAN 0 ,
ONTRACTOR:
iDORE55:
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kRC H/ENGINEER:
CDORESS:
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INSPECTOR:
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F I N A L
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MOD
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T1Apn55E MANSF IELI) AV
M O B I L E:
M/H PLACEMENT
Site
Number) 1 W 12 L 60 H 10
APPLICATION...
DATE 1
SE(i'0s:
00059
ATE:
04/27/84 I
PROD*:
00000094
Mobile Home iiista1iatio $50 , 00
FEES:
$ 5 0, 0 0
PAID eV:
CA
CIS.
X
CG
NC
COUNTER APP
PLANS EXAM:
DyT :/27/E
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H O M E' P"E R MIT
Zip -00000
TOTAL FEES $50 , 0 0
OFFICE COPY
0 4o-
I
385;7� *510,00�