1977, 03-23 Permit App: M0079 ResidenceCounty of Spokane, Wasi.ington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT d-o
GENERAL REQUIREMENTS PERMIT FEE .__V62
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
kind or alter any building or structure already erected, or to change a land use. Construction must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer' s Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45 -133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress
COUNTY ROADS. Work on street right -of -way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
Highway, clearance must be obtained from the County Engineer and /or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner !� .h �' g n .� P v E t Address
Architect Address
Engineer Address
Contractor « -1 Q Address
)p
Legal Description of Property (Give complete de cription from deed tax receipt, etc
46 t /.2/ I . y �, � zti. cc,
Q/ ce/
4(":(7
�/
Phone � —bi6/.
Phone
Phone
Phone
(2,3 $'J- ?x"27
DESCRIPTION OF WORK: New Addition Remodel
Size of Lot
Storie Dimensions 7
Rooms Baths / Baseme
(Full, part, no e
Heat. System, Ca Type of Roofing
Use of Bldg.
X30
6/
-a -
Foundation Con t
Moving
Sewage Syste
-ed Ext. Finish
PLOT PLAN
B,dg. Zone % Firef ne
- -- Const
Fr., Br., etc.)
Total Sq. Ft /7,; Valuati n
Chimney Fire lace
Kind) (Number
///
Int. Wall Finish
No. of Units _ Bedrorrs cQ
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH RESIDENTIAL — COMMERCIAL
State License No.
Ind. Ins. Acct. No.
REQUIRED
,e
Plumbing Permit ,a
slot
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify ormation submitted is correct and there are no other structures located on this property except > 2
er or Agent Date
A LAND USE ORC8`t'RUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PER 1T.
\j, ,:2;<-64-1-- DO NOT WRITE BELOW THIS LINE
Your street address will be ! i2 D b /- de r- 7 U2 The zone is / 5 % /C-
Sewage Permit Number Issued ilding Permit •,7- Receipt Iss
Remarks
as shown.
Fnrm A ?fl Rlrin_ Cnrde