1977, 11-29 Permit App: M4281 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE ‘5,-0
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of ani
kind or alter any building or structure already erected, or to change a land use. Construction must conform with tin
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 disturb:
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 al
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.
APPLIQANT FILL IN BELOW THIS LINE
Name of Owner . 72vt 72 _ice G i Address Phone
Architect Address Phone
EngineerJ r'"—�-- Address 'hone
� ,�/ -
Contractor ` 7 • �Z�v2 Address -0�o ...��17� f •• 9,- c?
one
Lege escr tion of tropertw (Give comp174 des ipti6n from ler, tax rec_pt, eta) Parcel Number -�� S W '- 3 /
DESCRIPTION OF WORK: New_ — Addition Remodel Moving BId Zone (
Fire Z ne --.3'Size of Lot 9Y , 6 0' ACS /c)? 1/, 96 Sewage System'1s
✓ onst.
, ` I �' .(.,/ Fr., C i Br., et )
Stories Dimensions -20 X Y-l'a5 <Da _A/'„?/0X13 Total Sq. Ft. - /Cf J Valuati5n .J?
Rooms Baths - - Basemen F undation Const `Chimne
!.
(Full,y Fie ce
part, no ( ind) (Number
Heat. System ( a Type Roofing •w , .. Ext. inish / 4. it/ . nt. Wall Finish G
- _
Use of Bldg. , - r• .,, ! �,.. - .i ,, 1, di i .. �, r• 5 No. of Units �3
_Bedroo
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
State License No.
as - r - -)7
-o ,J/-1 _FR .;
Ind. Ins. dcct..�No.
JJ -7;
7-{I%'-/ /�' �,
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
CL O'- ( l -
PI Heating Permit
N
N Sewage Permit
.4
-1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I her: by certify in . " ., s _, ' ed s correct and there are no other structures located on this property except
as sh..
f.
Ow or Agent Date
A LAND USE` R STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be (---2,./_/...1"241.-.0---/ The zone is -/ Gd7ns
Sewage Permit Number Issued , Building Permit
_.►
X01 Receipt ? dtI=/
Remarks
C7 ed
—
Form 523 Bldg. Code
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