1992, 05-29 Permit 92003842 MHSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permittapplication, state that the information contained in it and submitted by me or my agent to compile said permiVapplication is true
and correct, and authorize Spokane Count o proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to co ply ith sam . All provisions of laws and ordinances governing this type of work will be complied with whether specified
hereinornot. l understand that the issuan of is qer application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate orcancel the pro i o'iahy to or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction. ^ Z
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
i=`Fi_iJE:C;T Nl.lt'ilitEER::= 920193841" T.SSUE::I) PERMIT ur-I1:.: 05.-S'9/92 lo:l;r,:: :;;:
PERMIT INFORMATION tl')i'#3i#�M��)i��n:�x#)i�)r�)(•�A�#yr.H..ir it x�u yr#�)r 3i���r �)r �ir it�
SITE STREET= 11920 E: MANSFIELD AVE 0124 PARCELO= 09544-6i3iM
ADDRESS=:: SPOKANE. WA 99206
PERMIT USE= SINGLE WIDE:: MOBILE HONE:
PLATO= MH0045 PLAT NAME= PINECROFT MOBILE HOME PARK
BLOCK= LOT=: 124 ZONE= UR -7 DIST;– H
AREA= 000000017 F/A- A WIDTH= DEPTH== R/W:=:
0 OF BLDGS= 1 0 DWELLINGS= 1 WATER DIST = PINEECROFT MHP
OWNER= WAYNE, ,JOHN PHONE::.
STREET= 11920 E MANSFIELD AVE: 0124
ADDRESS= SPOKANE WA 99206
CONTACT NAME= ,JOHN WAYNE PHONE:: NUMBER= 509 928 ` 1 ` R
BUILDING SETBACKS: FRONT= 4 LEFT= 5 RIGHT= 5 REAR- '.-
MOBILE: HOME.: PERMIT
CONTRACTOR= OWNER PHONE.::::
YR/MAKE- 1970 MODEa._= BELMONT
SERIAL:* WIDTH- 12 LENGTH- 64 HEIGHT= 'i 0
ITEM DESCRIPTION QUANTITY FEE AMOUNT
--------------------------------- ----–.._.._.._.._
INSPECTION FEE: i 50.00
STATE. SURCHARGE Y 4.50
COUNTY SURCHARGE. 'f 9.00
1-'A'ri'IE::IvT ,iliiiiiARY �A:##ii.:a..ii��ii��xdriii4#:r'..h.di•�M��isir�x�ri��b;�i�:)�lii..tr:�r:�ru
PAYMENT DATE
RE::CE::IPTO
PAYMENT AMOUNT
05/29/92
4043
63.0
TOTAL_ DUE:=
0
TOTAL.. PAID=
..............._........_�,, D
PERMIT TYPE:: FEE
AMOUNT
AMOUNT PAID
------------ ..--.._......_..__...---.._........
AMOUNT OWING
i-iOBIL_E HOME PMT
63.50
63.50
.00
-- ._..........---- ----.._.._
-------------
63.50
..---._.._---_------
6,3 00
100
PROCESSED BY: JULIE SHATTO
PRINTED IitY: JULIE: SHATTO
THANK YOU