1976, 07-22 Permit App: L4821 Residence1Doerc oc atJS33— leoa
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Canty of Spokane. Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE 48.00
FERMIT 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.
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Lots 3,4,5,6 and 7, e cept the N. 9"0 ft and except'county
right of way, and lots 18,19,20 and 21, except the S. 90
ft and except county right of way, all in Blk JO. of
Bettman's Addition.
Perpetual easeme:.t for drainage over and across the
easterly 10 ft adjacent and parallel to county right of way.
a er-) require-n'sepnrnee-pe,wae. "
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 -
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Name of Owner CDN NIS 3W 0 R. Its Li T Address 09315 e• Se ellGOE Phone 35-0.35I
U Address // Phone C./
Engineer v Address 6 ---
Phone
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Contractor co A7 • cen7. carts., Address Phone
Legal Description Property (Gi�vf complete description from deed, tax receipt etc ) '
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Architect
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DESCRIPTION OF WORK: New Addition Remodel Moving BIdp° Zone Fire Zopq
Size of Lot 14'O - act) X 90 Sewage System 1 n+l V. Const -1-�
�t C (Fr., Conc.. Br., etc.)
Stories Dimensions a!J Xnn50 Total Sq Ft 1400 Valuation 3't IIICLI
Rooms Baths Basement JUL t- Foundation Const (3n At P_ Chimney A445 Fireplace I
t� Fu I, part, none'' �/ (Kind) (Number
Heat. System 4, 4 E .qq Type of Roofing C044 P. Ext. Finish )&— CYO Int Wall Finish 'D KV Cunt -
Use of Bldg. L'-' I 5 No of Units. Bedrooms 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.
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NORTH
RESIDENTIAL - COMMERCIAL
SOUTH
I hereby certify information submitte
as shown.
correct an
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
nr Heating Permit
NSewage Permit
N
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
there are no other structures located on
his pr.,.erty except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION CO MENCES.
THIS IS NOT A PERMIT.
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Your street address will be 1 L/ / q S (3 E 7"7:44 4 A f The zone ie
Sewage Permit Number Issued
Remarks Building Permit Receipt I/ 7 us
DO NOT WRITE BELOW THIS LINE
P.2/
Form 523 Bldg. Code
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