1977, 09-14 Permit App: M3324 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
J7
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 PROM 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 OP 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 C/9/ j� p
Name of Owner r' - • . £y i u • .dress t5 3 o t) / e/.}/ (i' phone %.5-3,57 76 /(
Architect Address ''YJ/. a -a- NU R/ Phone
Engineer , , j Address c�,J—>- .Phone
Contractor Vg./tttc � Zf Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number oil t6,4/ 2-3 00 .S!
.S0
Lot t' /3/ it-.' /9 /
F/3A/}�' 17/zwz' tiete0n,c &/ndt7.!/
DESCRIPTION OF WORK: New v Addition Remodel Moving Bld . Zone / Fire Zone
Size of Lot 50 Y /.2 S _ Sewage System '4 7474/1-1 CDost. ,h �..
�c, ' �7 ,, / (Fr., Conc., Br., etc.)
Stories `�CrDimensions a 7 YSa 22yars Qos-Hi?ir /UY/'t Total al Sq Ft 20 a.2. Valuation _•37000
Rooms . ?Baths 2 Basement r4// Foundation Const Co /t-'L`hK ?et Chimney "OteliR/Fireplace 9 --
-MTh, part, none .•t- ( ind) (Numbber
Heat. System Tyne of Roofing Co /y�P Ext Finish / / t / / Int Wall Finish Sgdp.Ilt i(O P/N
Use of Bldg. �G11..an. «.-�LiY/ %` No of Units Bedrooms 3
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; (8) location of sewage sys-
tem and wa er supply lines.
m
w
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N
NORTH
SOUTH
State Lice a o.
6�
Ind. Ins. Acct. No.
.�ESIDENTwD— COMMERCIAL
REQUIRED
Plumbing Permit
w Heating Permit
NSewage Permit
-1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
,1/2477 7
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
DON/O(�T �W�RITE BELOW THIS LINE
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7 / 7 vV///&t4, GC a1 --,e/ 14W The zone is
Issued Building Permit j,/ Receipt 7X� 'cp Issued
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Form 523 Bldg. Code
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