1978, 03-09 Permit App: M5223 Residence9,
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
�L/I O
APPLICATION FOR LAND USE OR STRUCTURE PERMIT `�a 7-
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 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 47235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, pf 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.
RESTRICT•IVE 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
7 •,.1-, /
Name of Owner ✓1"d-0�-' ( Address �+ /J ✓. �[ _ _ a. _ Phone qAM-�8�(�
Architect Address Phone
Engineer f��)Address / Phone
ContractorVA-ad Pez-114 / ;6:11W
}- 11W-enJ Addressyr .SZ 2 / 344421 Y�0 phone 9-22-/7/1
Legal Description of Property (Give complete description fro deed, tax receipt, etc.) Pa c Number
crs // /-2-/3—/$ ,Ci.[JKS L3Q,1tagQ- EX
//tie -/.1 wiat Exe . a yr/' ops /.34-11 '5 Lc'
ggaa-
ROADWAY R/W WIDTH b °
DESCRIPTION OF WORK: New :� Addition Remodel
Size of Lot Q'/e, X /00
., /
StoriesLL Dimensions 07..iA' 3%, n
Rooms Baths F , part, i fra te
art u 1, sem no
Heat. System art-- fy Q Type of Roofing
Use of Bldg. ,e,_.q.l,CiPir.LNZ
Moving BI . Zone _1— Fireon
Sewage System
�q1 Total Sq
Foundation Const Cl
l=P'DYLfO. Ext Finish
/, (Fr., Conc., Br., etc.) OG
Ft nil Valuation.SV0O�
Chimney AM Fireplace NA
(Kind/ (Number
Int Wall Finishnt-etwon
+�
No of Units _Bedrooms
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.
m
to
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NORTH
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wG icPP cb„,„l
SOUTH
State License No.
6 K o& F/<.E
Ind. Ins. Acct. No.
/1-/0-7P
RE HENT L- COMMERCIAL
REQUIRED
-- Plumbing Permit
m Heating Permit
SP
N Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
rYWOFTWIS
Tour street address •111 be / i - -_ (- _ - - /� ( �. U ' e zone is (,"`'�n,(tGK
Sewage Permit Number ,Issued wilding Permit Receipt O.5'3 Issued
Remarks 7�1/ 12k(7 ..1 ., +
Form 523 Bldg. Code
2
3
Request d I'rI L
Lot Cost
PLOT PLAN
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Scale: j --{U
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ad'
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ATIONS:
Crown of Street
Finish Floor + /0 —
llasic: J
PllA Case it
Sq. Ft.
t ct4
Job 4
Legal/.o'tS I!� l2, , 3 di/ L o� 8 e �'t, .'- a d ,f�, '
ftc. r drej IV,'ip( C (-)( pl,t(s P 1,13 , u, :;� i,ok.,. r Cc_ -..4.y, W.c
N, `7& 04_Lci-s (Ifl.7. 61&d &koex t,,e3, `(U'•'c 1—:l.s /3i /'/ &Cc,'t.-d
Acl(lless 'l -',e Y.t of = 14 T.25 kJ R`/3 ecii,y)
Mortgage Co.
Parcel If
;1ti53 -73
Power Co.
/-z)
LX)
11.1lumber
(dater Co. 72
GJ L) /
Excavator.
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NWCS FORM :L�-