1992, 01-02 Permit 92000006 MHSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WAPHJJGTON 99250
(509) 45? B75
I certify that I have enm fined 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. AI I 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.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 9000006 ISSUED PERMIT DATE= 0/02/92 PAGE== 01
********** PERMIT INFORtMATION
SITE STREET= 11920 E MANSFIELD AVE :054 PARCELS= 09544--6048H
ADDRESS-= SPOKANE WA 99206
PERMIT USE= SINGLE. WIDE MOBILE HOME
PLAT''= MH0045 PLAT NAME= PINECROFT MOBILE HOME PARK
BLOCK= LOT= ZONE= RMH DISTO= F
AREA== 00000000 F/A= A WIDTH= DEPTH= R/W==
,I OF BLDGE= 4 DWELLINGS= i WATER DIST =
OWNER== VANWERT, ED PHONE= 509 922 6567
STREET'- 18007 E RIVERWAY AVE:
ADDRESS= SPOKANEWA 99016
CONTACT NAME= ED VANWERT PHONE: NUMBER= 509 92 6567
BUILDING SETBACKS: FRONT= 5 LEFT== 3 RIGHT== 3 REAR= 5
**irirxa�xxu*�*#x aux MOI:iI.LE HOME PERMIT •x�x�x��#�� ����r� �#���x*mit <x
CONTRACTOR== OWNER PHONE=
YR/MAKE= 1978 BROAM MODEL=
SE.RIAL..x= WIDTH== 14 LENGTH= 70 HEIGHT= 10
ITEM DESCRIPTION QUANTITY FEE AMOUNT
----------------"---"-----'-- -------- ----------
INSPECTION FETE i 50,00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE: Y 9,00
PAYMENT SUMMARY
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
01/02/92 00002 63.50
-------------
TOTAL
------....-------'TOTAL DUE= .00 TOTAL PAID= 63,50
PERMIT TYPE FEE AMOUNT AMOUNT PAII) AMOUNT OWING
--------------- ...------------.
MOBILE HOME_ PHT 63.50 6& 0 .00
--"---------'- ------"---
-----
--'- 63.50 63.50 .00
PROCESSED BY: .JOHN LARSON
PRINTED BY: JOHN LARSON
THANK YOU * � K• •�c * *�c�c �.;..k x ###