1978, 03-09 Permit App: M5222 ResidenceCounty of Spokane,. Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE. WASHINGTON 99201127/9
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 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 mast 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 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.
�j APPLICANT FILL IN BELOW THIS LINE
Name of Owner /eny e r' v0 t, PG r Address Phone
Architect Address Phone
Engineer __//�� r //� Address < _ II � �1� Phone �/
Contractor \'Q rIPQn S toG Crier iS.�S Addressc) c7.,),/ T h v7K'. Or PhoneQ?K /a/lr
Legal Description of Property (Give complete description from deed, tax receipt, a c.) Parcel Nun,h�Jpr 2145:33- /1'�d.�
e .S. Rte' OF L. %3 t,S. 90' of L. /o�c 5 /Ja%trna•s !� ,1
• 6 r
9 D-7- / 7/A
C-
i0
aeQta.,4 Sw YF% oF' S 2ti, 7 �51�J,' . 4' C.rv.., °
ROADWAY R/W WIDTH C 0
DESCRIPTION OF WORK: New V Addition
Size of Lot 90 ' i( 11 $00,"/
Stories 4 Dimensions �3 er '
Rooms q Baths ) Basement Ftt 1�
(Fu(I, part, none)
Heat. System Type of Roofing
Use of Bldg. S ) 9:5)Q. }SCF r)', f 1
Remodel
Moving Bldg. Zone / Fire Zone 3
Sewage System 1w)01., Const.Yr'
(Fr.. Condi. Br., etc.)
/� Total Sq Ft 79 y valuation( C9,06d
('
Foundation Const ,nnL•('ef C Chimney Nbna Fireplace No0t
kilt
(Kind)(. (Numbs rn
G Ext Finish77 l/ ?'9�n/ Int Wall Finish'✓' �l Wk// -, ]0Q 0T
No of Units1Bedrooms �-
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH
I hereby certify
as shown.
SOUTH
,,r.c�State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed _.
5/V7 I
oration submitted is correct and there are no other structures located on this property except
-J
1(1 C/ .797
Date
er or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
61-vo 714,z a
DO NOT WRITE BELOW THIS LINE
Your street address w111 be /2 2 / DS ! e
1141. tat
Sewage Permit Number Issued //// Builddii�ng Permit
Remarks CCr/ o (c 2141'�w
_t,l tom-' <19' " I''aI
f�{�Ci�Xy1 4i BON, f5$C O'1) ue A&J. — Co.rAKUCI� �Ikarth§ ri,A/.y .— Ca r
"fF erri IT Asyno 1Cao SOB.LLL'
Form 523 Bldg. Code
The zone Is
.!
^,[.1 /.l.li LL4
Receipt/ -5:3 Issued
Czofor adie . IM7M'
g
P1'.Illr;iI'd Pr Lee
Lot Cost
PLOT PIAN
Scale:
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Basic:
h7y
IIIA Case #
Sq. Ft.
Job'#
V TOS, :
Crown oL Street
Finish Floor
h "`
13
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�eck�cC.;(d.a i fA. L c,,.l r-1 i' �1,e :3U %/ cd .1;„414.7-45h, y'i c
Address
I,Morl gage Co.
Parcel. #
r+ C /
Power Co.
1'Lumber
Water Co.
41-tJ uta
Excavator
Lou51111augb
c / c 'ruol}I *t
v ` 11
NWCS FORM #L—