1978, 01-16 Permit App: M4584 Residence0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 r
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 4"
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 most conform ■Ith the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. (later 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 8=1 47235.
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.
d O
APPLIC T FILL IN BELOW THIS LINE
Name of Owner 2 L — 'a' Address / O R 2-S'-- e2-.3 Phone? 2—r? iSrJ
77Cf
Architect Address Phone U
Engineer
Contractor .L-2/ ,,[ Address
.L-2/r.� til V
997 c) 6.
Address --
Legal Description of �Pjroperty�f(Give complete description from deed, taxerreceipt. etc.)
Zvi T /7 4- 41 3/7an[-,4'& . &.4 /11
Parcel Number
Phone
: 5'52 / 040
DESCRIPTION OAWORK: l w
Size of Lot 7 0 /
Stories 4Dimensions 4/ 2 "
Rooms 7 Baths Basement
(Fu , part, naw:
Heat. System (/.ltt . Type of Roofing
Use of Bldg.
Addition
Remodel
et Foundation Const
e.,../7-1 Al (a Cy
Moving
.1.. pSewage System
�` l -'total Sq
g. Zone / Fire Zone3
oust.
Fr. Conc. Br. etc.)
Chimney ireplaceZ`"-'" ^ Q
in (Number
Ft /g2-0 Valuation v
Ext. Finish T- I-- (
Q rTi¢-e-WC
PLOT PLAN
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.
Int Wall Finish
No of Units _A.Bedroo s
3
NORTH
SOUTH
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby ify lnforma _submittyr is .rrect and there are no other structures located on this property except
as shown.
Ownerr gent , Date
A LASE OR STRUCTURE PERMIT MUST BE ON TH REMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT. /
0n�-744.441010 / DO NOT
/%�WRITE
�BELOW THIS LINE ¢
Iour street address w111 be 3 6 /7 �r V/ -/ v5 I� / 7 ��The zone Ss,J/ �%G-LL-
Sewage Permit Number Issued Building Permit 4 Receipt/a t3 Issued/
VVV
Remarks
Form 523 Bldg. Code