1978, 02-24 Permit App: M5014 Residence4
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County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 992011 ,),
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APPLICATION FOR LAND USE OR 'STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
PEWIT 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 f�e,
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 higineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property fine, 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 OP 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 ✓ S. J R M >, ESo#J Address ///Z3 E 3a r, phone 7 / D -P / 7<1
Architect Address Phone
Engineer Address Phone
Contractor 0 F LTA C on t OA uY Address /// 2.3 3oy Phone -/S7Y
Legal Description of Property (Give complete description from deed. tax receipt, etc.) Parcel. Number X354 / ct0!96
Lor tc /3ZMC,e G 41/v/Gom.E
r
DESCRIPTION OF WORK: New K Addition Remodel MovingBld Zone .
g. —�— Fire Zone
Size of Lot /00 X /CO F Sewage System SG'wCZ Const. �'e
V / / / �/ CI EC O.T /-1 //$ 7c1 Fr., Con 'Br ,, etc.)
3 x ` 1 / A.., G.4,e444 Con......
Stories / Dimensions oral Sq Ft � Valuati ern
Rooms 5 Baths o�7 Basement ,cZX. - Foundation Const Co.t..� tetra Chimney /3�� Fireplace /
��1I TFuII, part, none (Kind) �-7 (Nymber
Heat. System /C,4 Type of Roofing CO�7.p Ext Finish -7.-- /—// Int Wall Finish /2/
Use of Bldg. .6/ 41G! s /2� 5 /40,x4 7G E 1 te.4.. S' SLLaA ... No of Units ZBedrooms 3
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.
no
no
NORTH
5Ala 7-cN /4 7-7.-ACWEn
State License No.
DE • LTo ,4 G.247, y,
Ind. Ins. Acct. No.
RESIDENTIAL COMMERCIAL
REQUIRED
Plumbing Permit
wr Heating Permit
• Sewage Permit
H
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby c rtiormation submittted is correct and there are no other structures located on this property except
as show//
7p
OwnerOwner or Agent Date
A LAND USE OR STRUCTURE PERMI MUST B ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A P RMIT. ,/ Q� (�
6. QP DO NO WRITE BELOW THIS LINE
Your street address will be `---� CQ 5 The zone is&f s---7./7241
Sewage Permit Number Issued Building Permit Receipt /)3 D g Issued
Remarks I�
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Form 523 Bldg. Code
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-DEUA-COMPANY
SPOKANE,
11123E MbASE.
WA-89206-
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