1977, 03-20 Permit App: M5350 AdditionCounty of Spokane, Washington 1 °
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.
SEWAGE 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 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 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.
Phone 9z8--4,44S�
APPLICANT FILL IN BELOW THIS LINE
Name of Owner LA IJ Address
Architect Address Phone
Engineer ,QQ
Contractor ,.QCl„iv4.X..
Legal Description of Propertyve c m lets de riptio from deed, t x re eipt, etc.) Parc Number
Pa RT �i.c-K �Do rLl�� ti�
L-3 ,EG AT NF e...,4 2. 13.41( / 6 TIC _ 2t) 7/-f. / J j,T ' 74
Tn. ill. 77..3' TR. 5, 15i ' Td. PE .20 ,7.2/ I,v.le AAl.
ROADWAY R/W WIDTH
DESCRIPTION OF WORK: New X Addition )(
Address Phone
Address Phone
Size of Lot 77 k /L -5 -
Stories _L___Dimensions ,2
Rooms _L_ BathsJ� Basement (V A
Fu(I, part, none)
Heat. System . Type of Roo
Use of Bldg.
Remodel
Sewage System
POO.
L3,oK
Moving Bldg. Zone Fireone .
ryonst.<1i►I-Qimtt-t
(Fr., Conc., Br., etc.)et
Total Sq Ft s d Valuation . yew
Chimney N Fireplace' 1
t2 d// (Kind)rt. (N u ber
al nt. Wall Finish 4
A/ A
Foundation Const
Ext Finish
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 acd streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
No. of Units Bedrooms
NO R T H
SOUTH
I here certify in2irmation submitted is correct and there are
as shown.
1�d1^-'
/Gater
Owner or Agent
State License No.
Ind. Ins. Acct. No.
- COMMERCIAL
REQUIRED
Plumbing Permit
rn Heating Permit
HSewage Permit
no other
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
8/O) 5/
structures located on this property except
—.2-6— 7
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
15
�¢25
Your street address will bet , 77 d 8 '� ,(,� (°h 2�r / d The zone is
Sewage Permit Number Issued Building Permit 4 Receipt d 7.2. Issued
Remarks 1 V 1
,PdK�
form 523 Bldg. Code