1977, 03-16 Permit App: L7469 ResidenceCtnfy of Spokane, Washmigfon
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
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.
SEMIA*E+SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property lii1 " of -rt
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.
APPLICANT FILL IN BELOW THIS LINE
• /
Name of Owner e'i�Ad.4.Q�L.�!/ _ Address dkf� _' ' / 9a Phone j k 7- 4-6-2-5-
Architect Address Phone
Engineer Address Phone
Contractor /L/va0 Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc )J 1 I PDRT- 3- OOk
hoT ELK' 1'1, c.
DESCRIPTION OF WORK: New , X Addition Remodel Moving Bid Zone / Fire
Size of Lot / 6 4.- x / / S' Sewage System Bid?. Zone
- onst. '�+�-
/ /1 ,(Frr.., Conc., Br., etc.) p
_(%
Stories Dimensions a. X ./.., f n/Z6�
x - F> X 1 G DK SC Total Sq. Ft 43 "�ivu� J[ajuation /11-,/75 G
Rooms 12_ Baths 2 Basement—7-U-QY .Foundation Const. C APZi Chimney 1 Fireplace/.v�
(Full, part, none (Kind) )4 Nurgber
• Type of •oofing Ext. Finish —// Int. Wall Finish A ` '-
3
��� No. of Units,_ Bedrooms
Heat. System
Use of Bldg.
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
RESIDENT! BrL - COMMERCIAL
Jez QltaAe.et
State License No.
Ind. Ins. Acct. No.
S/7/77
REQUIRED
Plumbing Permit -
rn Heating Permit
a Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and t• re are no other structures located on this property except
as shown : v. J 1 !y j°" ��'` GG �- i : 1
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS N,O1 A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be 14 02.-) .,ed,
Sewage ermit Number Issued
Remarks
The zone is _'(J4 -(&-i-:
Building Permit - ;( - Receipt 4L'7f Issued
Form 523 Bldg. Code
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