1977, 05-20 Permit App: M1972 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 .
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APPLICATION FOR LAN® USE ®R STRUCTURE PERMIT
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GENERAL REQUIREMENTS PERMIT FEE .___Asv'__._
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.
NATER. 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.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner, / Address 3��% ,% �26Y,2--Phone 6E3L5 �y 4-11—
Architect Address Phone.
Engineer Address q Phone
Contractoram�_A Al �` Address 95041 Phone 0�
ZL gal Description of Property (Give complete Oescription ffrr�ojn deed, tax rec/e. t, tc.ISparcel umber 3 -19
-DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. one .__ Fire Zone
Size of Lot — n- T- ° Sewage System '• onst.
JX -�o%f / /}C � // LL �Fr., Conc., Fir-, etc.)
Stories Dimensions Total Sq. Ft..LL `Valuation'' y/, 0dU, u`�
Rooms Baths Basement . �w Foundation Const.. Chimne v ,Fireplace 2-
Fu 1, part, nonce (Kind) (Numb�%
Heat. System t� Type of Roofing < <tlmy-4 Mt. Finish Int. Wall Finish
Use of Bldg. v � No. of, Units .Bedrooms
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines and streets; - (5) dimensions of buildings;
tem and water supply lines.
g
N
NORTH
SOUTH
(3) location of existing and
(6) location of sewage sys-
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
o
Plumbing Permit
M Heating Permit
H
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information subotted is correct and there are no other structures locatgd on this property except
as shown. . / 1 4 " 1 /I a . /---7
I
Ower or Agent DKte
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PER►IIT. n
Form 523 Bldg. Code