1978, 03-01 Permt App: M5172 ResidenceCu mfy ®f Spokane, Washedgt®n
2
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 j
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
d%
GENERAL REQUIREMENTS PERMIT FEE ._____Y__--------------
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, o 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 in g ss
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.
4 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. Robert A. Long Address *� �u+�-r Phone -t -r- �`�
Architect Address ! T� z Figs % Phone /p z-- 1146
Engineer Address Phone
Contractor a Address _ Phone
Legal DensJU0ripti ; f Pllr�f erty Ti�ehcoem mAsc igt og rr deed, tax receipt, etc.)
DESCRIPTION OF WORK: New X Addition Remodel Moving Bldg. Zone 1 Fir Zone 3
Size of Lot 80'x 130,x80,x 130' Sewage System 'Sep 'lank onst. Frame
Aa ,, oo ., ,/ s� �Fr., Conc.,,�Br�., etc.)
Stories Dimensions Zit x `ice 2¢ X �+ Total Sq. Ft. (� Valuation, �_
ry
Rooms Baths concrete masonBasement Foundation Const.. Chimney replace 4
Full, part, none (Kind) FY t dN tuber
Heat. System F'' Elec Type f Roofing Shake Ext. Finish T1-11 Lap Int. Wall Finish Sheeock
of BI 9•
j�e No. of Units
/ L 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 ar-d,streets.;_ (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines. �-- - --�\
NORTHRESIDENTIAL - COMMERCIAL State License No.
LO-HG-:,R-A2h_6R0
Ind. Ins. -Acct. No.
327-551
SEE ATTACHED PLOT PLAN REQUIRED
Plumbing Permit
m Heating Permit
CA H Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby cert'P4 j format'on submitted correct and there are no other structures located on this property except
as shown.A.-A 17 7 SI
Owner or Agent y Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
DO NOT WRITE BELOW THIS LINE
Your st eet address will be L• 9715 Crossbow Ct.
� Th�e zone is
Sewage Permit Number Issued Building Permijk _]�--11Rceipt Issued
Remarks
Form 523 Bldg. Code
1i.