1977, 12-08 Permit App: M4363 Residencei 0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT.��-J �O
GENERAL 'REQUIREMENTS PERMIT FEES/
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. 45-133m147.235.
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 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.
ICANT FILL IN BELOW THIS L E
Name of Owner //!�L!/./L/S�_ �/./1 Address & • Phone0,--a
Architect / / Address Phone
Engineer �Address Phone
Contractort-7(201761,/Address
Legal Desc-ption of Property (Giv: complete description from deed, tax receipt, etc.
Parcel Numb
DESCRIPTION OFWORK: New( 1 Addition
Size of Lot ;7 X ,[35 _ i1
/ i i, i
'Stories Dimensions�7G. - _`a' '>`.
Rooms % Baths , Basem:nt 1. .d1
�^ t 11 part,
Heat. Systeme t ' 4 pe of Roofing _1L/. 4
Use of Bldg. i / _" /, _ / .t_ ._ �.'.
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.
Remodel
Foundation Const.
E
Moving Bld .Zone Fire n✓e ��
Sewage System
to const,-
pp (Fr., Conc.,
(.l Q/ T• al Sq Ft �/
tion�
s& - -,- Chimney Fireplace
(Kind) (Number
Int Wall Finish �+/�a
No of Units —Bedrooms
sz�W
Fines
�L-a14.
PLOT PLAN
m
N
N
as
NORTH
--gietkfiyg cond
I
certify inf
50 'TH
witted is c
Ow, or Ag
A LAND USE OR UCTURE PERM
THIS IS NOTA PE T.
Your street address will be
c te icen ee Flyy.
Ind. Ins. t. No.
RESIDENTIAL- COMMERCIAL
REQUIRED
Plumbing Permit
�n Heating Permit
Sewage Permit
-1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
and there are no other structures located on this property except
—8-11
Date
MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
4
�,..Sr fl -tet et-
�� Buildi Permit Ti Receipt Qqi/O Issued
g363
Sewage Permit Number Issued
Remarks
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Form 523 Bldg. Code
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