1978, 03-27 Permit App: M5437 Residence•
County of Spokane, ' Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 0 0
GENERAL REQUIREMENTS PERMIT FEE 7'
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, 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 f,
Name of Owner `-SA'J w MtDom ak� Address A) ll O t W hddEt, 2R Phone 4M
-3yS/
N
Architect /4 Address Phone
Engineer Ad A Address Phone
Contractor CA/ft- Address Phone
Legal Description of Property (Give complete description from deed• tax receipt, etc.) Parcel Number! } I'V /�.f V2 - 90d -I
2or 6 . Block / - yf4a/A/r Nd/JJ17 /9" 4/1
ROADWAY R/W WIDTH Ge 3/ Gt
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone Fire Z.4.c..C.�
t
Size of Lot 90 X i SV r Sewage System SLaftd onst
_ �/ 1Fr., Gtonc. Br., etc.)
Stories Dimensions 92'A L7 '� .73 X.211 ' ,,11 Total Sq Ft �"5/� Valuationtl2,000
Rooms L Baths Z. Basement _Cal Foundation Const L•04vcrt&/S Chimneyfarm't Fireplace Z
Af (Full, part, none—//11 / t1 ,f (Kind) (Number
Heat. System CA- aic• Type of Roofing `Oe1,, ( n� E t. Finish hJae JSiryilut Int Wall Finish .)%,,A,,
/� pp u
Use of Bldg. Drit M tars I 124-.G�-� Cj' No of Units Bedrooms 3
o PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
oposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
m ,d water supply lines.
-I
NORTH
SOUTH
I hereby Fe tify infoyxptio ubmitted is correct and there are no othstructures located on thys„ptoperty except
as shown l/ . ,/(/ ! g2-_ 2 Of/
State License
®r< Ort
Ind. Ins. Adbt. No.
CR-ESIDENTIA -COMMERCIAL
REQUIRED
Plumbing Permit
w Heating Permit
ts Sewage Permit
-I
Plans Received
Plans Checked
Pians Returned
Plans Picked Up
Plans Mailed
Owner or Agent Date
A LAND USE OIt STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
IS ISjJOT A PERMIT.
�, /{( DO NOT WRITE
�BELOW
pTHIS
LINE C
Cr 04( �1 street address will be E . // 022- ilia -t t.Z_/ me zone is t�cd / _ � -
• Sewage Permit Number Issued Building Permit i'i-543h Receipt BQ� J Issued
Remarks
Form 523 Bldg. Code •
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ALIEN