1992, 03-04 Permit App 92001238 MHSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKAN , 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.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER:::: 92001;'.; 38
APPLICATION DATE:::: 0.T/04/92
•,,:) t•** THIS IS NOT A PERMIT 3f:R'n: •3 ,,;
PENALTIES 14TE...I... BE ASSESSED FOR COMMENCING Ni`:1:NG WORK WITHOUT A PERMIT
SITE S T F I : E : T :::: .f 'sr 1 '1 aL f:: CANE I";1: R
ADC?I:t°I c • c RF:f=r' AC=Rr ' WA 990116
PERMIT f.) S F.::: DOUBLE WIDE MOBILE HOME
I•''AFECEl...r: .. 1 5 53' 523
I"'I...A'r4 :: 001407 PLAT NAME:::_ LABERRY l Y MCiB1:I...E F'1"Ift:k,: ADD
AREA:::: 00000000 1= /IAi= F WIDTH::: DEPTH::::
OF BLDGE= i 4 T;WEI...E...1:N'Nt:;,.= j WATER '{)1:S•T -:
OWNER:::: VANDEF DOES, DA I!.:% n T•tRE NCy ; E='rii:'iNE::::::,
STREET:::: 19114 f:: CANE I';,I:R
AD>)RESS::: GREENAt.:kE- > Wt1 99016
CONTACT T NAME:.: BRf' NDA 'V AiNDER 'MC)r: r PHONE NI..IiiJtF::; <Y'::;i..{.
BUILDING SETBACKS: FRONT: l f::F"{':::: f :fGHT::::
S d
'1�::4:**.y(.li,..M*******1C•*$:lt.********7S'•Yk** REVIEW INFORMATION 4**:�G**ri..�;..r:�..4;;,,.fir:�,;.i,::�i-•;::N::r...:
DEPARTMENT
yR'rMr NT
RE:VIEW COMMENTS
BUILDING SETBACK REVIEW REQUIRED I I..11=: A E_ T h I i> :f.....T. l' i' i +"'' I ' r r, ` l: i`1 !' i "i' f': f'"t ut l ' `y F' 1W1to
CONTRACTOR:.:: OWNERy
f•R i'MAK I. = 1972
aERTFA,L..4=
ITEM DESCRIPTION
INSPECTION T.c:) FEE
STATE SURCHARGE
ti:::
M c):D F.: E...:: r:: I -I t' i'4 I:' :f I:: i
W.r. D TFH:::: '4 LENGTH:::: 60 L.Ef:1: GF.I T :::
QUANTITY
-y
r:I:-I:- AMOUNT
COUNTY SURCHARGE
•r i •:::.
PERMIT TYPE F:•r::f_: AMOUNT AMOUNT PAID D AMOUNT I:.'ii
MOBILE HOME PMT 122,50 ,00
122,50 00
f ' R i::) O : ' > f:1 BY: j U L..:E: l=: ,c; I• I , ....
PRINTED BY: JULIE ; Ht.T..T'£:)
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• $ ' ; * * THANK P E YOU rt •Hi •A' * .R..vi * * ';k ?t• •R• 9{. •M• tip• :![ •tG * -)(• h * ie• ik •JC * Ai P: * .p4 ;n; t'4 4 :k -*
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
STREET ADDRESS:
CITY/STATE/ZIP:
INFORMATION WORKSHEET
SUBDIVISION:
BLOCK:
LOT AREA:
LOT:
F/A:
ZONE: DISTRICT:
WIDTH:
DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: PHONE: -
c7
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT:
PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
****************************************************************************
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
BUILDING INFORMATION
PHONE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS:
X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
Please provide the following information for Energy Code compliance:
Space heating type (check one)
Forced air electric
Forced air gas
Electric baseboard or wall mount
Heat pump
Propane
Other:
Flat ceilings R Doors U
Vaulted ceilings R Windows U
Above grade walls R Glazing area %:
Below grade walls R Total floor area
Floor R of heated space
Slab on grade R Furnace efficiency rating
Please indicate on your plans: The location of the radon vent, and the location of the vent fan area.
Square footage
Main floor:
Second floor:
Basement — Finished:
Unfinished:
Garage:
Carport:
Decks:
Additional Areas:
STATE OF WASHINGTON)
ss.
County of Spokane)
RICHARD L. WYNNE, being first duly sworn upon oath, deposes
and says:
1. Affiant was the real estate agent involved in the sale
of property by Jeffry V. Ross, as Trustee, for the use and
benefit of Susan L. Clark, to David M. and Brenda B. VanderDoes.
The property is legally described as:
Lot 23, Block 6, LABERRY MOBILE PARK, as per
plat recorded in Volume 8 of Plats, page 63,
records of Spokane County,
Together with the Mobile Home located
thereon;
Situate in the County of Spokane, State of
Washington.
2. Affiant personally measured the property and found that
the double -wide mobile home is set back from the property line in
the front yard more than twenty (20) feet; from the side property
lines more than five (5) feet; and from the real property line
more than ten (10) feet. The mobile home is situated within the
above boundary and will be maintained that way.
1992.
Richard L. Wyn e
SUBSCRIBED and sworn to before me this
day of March,
NOTARY PUBLIC in and for the State
of Washington, residing at Spokane.
Commission expires: / /
MY COMMISSION EXPIRES
APRIL' 23, .1994
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