1977, 08-26 Permit App: M3039 Pool•
1141.1111011
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
0- 0
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 au 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.
�/,,,000,_��1 APPLICANT FILL IN BELOW THIS LINE
Name of Owner Q • (( ,el -reg -Z Address -,
Architect '�` / Address f���l-C/6 Phone
Engineer Address Phone
Contractor Address Phone
Leg I Description of o rty (Give complete de=cri tion fr deed, tax rec:ipp etc.) Parcel umberjury - 077
or 4 ,
Phone 9rqy 5-067 067
DESCRIPTION OF WORK: New Addition Remodel
Size of Lot a 9'7- 2 '71, T ,a �T'9' - a
Stories _Dimensions (iCl' JL y0,
Moving Bldg. Zone / Fire Zone
Sewage System S� onst. 1 / m %r L•
(Fr.. Conc., Bre„ ejp
Total Sq Ft FOO• Valuation T•y(/v'
Rooms _Baths Basement
Fu I, part. none-)
Heat. System Type of Roofing
Use of Bldg.
Foundation Const Chimney (Kind) Fireplace
(Number
Ext Finish --- Int Wall Finish
No of Units —Bedrooms
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
75,
276..0'
to'�ro Sol/
av roo
SOUTH
11.5'n Q_
I hereby certify in =ti.• submitted is
as shown.
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
-1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
d there are no other structures
/located//op�/t/hiis property except
ner or Agent
Dat
A LAND USE • R STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
DO NOT WRITE
BEBELOWTHIS LINE
Tour street address will be• -o bc -(f 6i1,s2 /-�i U l6-ri-r- 0 e zone Sl
Sewage Permit Number Issued Building Permit ReceiptIssued
Remarks
Form 523 Bldg. Code