1977, 09-06 Permit App: M3140 Fire Damage•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE..<d
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 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 _ one
Architect Address Phone
Engineer Address Phone
Contractor .-' -C9J) z4n" Address '92 7-7.- 0/�� Phone ¥89-S962
description fr;, deed, tax r-ceipt, etc.) P. cel Number C354.Tfl._R — O7/4
I // .- ..
Legal 1 ascription of Pro
�j
?b"
rty (Give.„.mple`
DESCRIPTION OF WORK: New Addition
�05L'(
Size of Lot
Stories / Dimensions
Rooms Bath
Heat. Syste
Use of Bldg.
Remodel
Moving
Sewage System
Basement
I, part, ndii
Typelof Roofi
/S-) i7 -f-4 O
Bldg. Zone
Total Sq. Ft
Fire Zone .3
Co
Fr., ,Cbnc j, Br., etc.)
Valuation A2 09-0
Chimney Fireplace
(Number
(Kind)
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.
m
-I
NORTH
SOUTH
I hereby certify information submitted
as shown. .
State License No.
Ind. 1 s. Ac t. No.
I/i77
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
s correct and there are no other structures located on this property except
ner or Agent Date
A LAND, USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number
Remarks
//3O3 ZCV1
Issued 'Building Permit
The zone is
Receipt %._( / I / ued
23 Bldg. Code