1977, 09-19 Permit App: M53464 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS
PERMIT FEE
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 mast 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
Architect
Engineer
Contractor
�r hC,
c¢ /4 c
Legal pescripti o1 Proper (,Give c plete description
Address / $ ✓ CoL)q '- hone
Address .� f 79(9. PF S e Yl Phone
Address / d 9 �� o j�� fl P Phone
Address /y Z-U6 � / Phone
from deed, tax recei etc )
�t / 4
/ 0 !7
05
DESCRIPTION OF (WORK:
Size of Lot // 6
/
Stories `
Rooms -5—
Dimensions
Baths
Heat. System �/
Use of Bldg.
New X Addition
/ ;3 0
/X Cep
Remodel
Moving BI . Zope / Fire Zone 3
T F r., at. e
Conc., Br., etc.)
Valuation. U U.
ireplace
(Number %
Sewage System
Basement %f // Foundation
uII, part, none)
PG�^ e-Type of Roofing a 0
Const
T al Sq. Ft
C5
hry
`� Chimney 0
Sl (Kind
/d/ 1--1- t. Wall Finish
o. of Units 2 Bedro85ns
/-rte
Ext. Finish /4 - 7
7,0s�
PLOT PLANL/
Draw sketch with dimensions showing: (1) property lines; (2) street or..:, 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
I hereby cent_
shown.
SOU TH
State License No.
Ind. Ins. Acct. No.
REQUIRED,��
Plumbing Permit
Heating Permit
Sewage Permi
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
Information jbmitt d is orrect and there are no other structure
Owner or Ag 'nt
located on this property except
ate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION
THIS IS NOT A PERMIT.
7
DO NOT WRITE BELOW THIS LINE
Your street address will be / z//0 (/ 9 , , , -I6.
Sewage Permit Number Issued Building Permi
Remarks
The zone is
Receipt
COMMENCES.
Issued
Form 523 Bldg. Code
1301
3Z-C)
0
1
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0
HOUSE
PPROY.,
iZ49
R/1,6 E
2 4"
-
30' LF
30 H A LF _
3011...F
0' vi
30 'HALF
LF
DRY WELL 36HALF
::0:HALF
I0 .O5
IBC) DRAIN HELD
!000 GAL.
SEPTIC TANS
SCALE
LOT c,
BLOCK