1978, 05-02 Permit App: M6126 Residence101
County of Spokane, Washington o b
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 4�4
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE.____ ,
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 mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. (later 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 CBC -RC AddressP.O. Box 2704 TA 99220 Phone 838-6567
Architect Address Phone
Engineer Address Phone
Contractor CBC—RC AddressP.O. Box 2704 TA 99220 Phone 838-6567
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number
Lot 19, Block 1, Fairacres Replat #2 Parcel # 09542-1119
11217 East Fairview
DESCRIPTION OF WORK: Now Addition Remodel Moving Bldg. Zone Fire Zone_
Siz of Lot 80' X 150' Sewage System Septiconst. frame
�Fr., Conc., Br., etc.)
or s l Dimensions 28' X 34' , 8' X 10' Total Sq. Ft. 1032 valuation $43.950
Rooms 5 Baths 1Basement fiill Foundation Const.. concrete Chimney TSS ireplace 2
Fu I, part, none -T (Kind) (Number
Heat. System Elec. FA Type of Roofing CQI= Ext. Finish T1-11 Int. Wall Finish ShPPtrQC1C
Use of Bldg. SF residence, deck attached No. of Units Bedrooms 2
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
See plot plan attached
State License No.
RC CO N279 B H
Ind. Ins. Acct. No.
RESIDENT L — COMMERCIAL
REQUIRED
Plumbing Permit
M Heating Permit
30
{A
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
,2/a 7A f --Y, '
t SOUTH
I hereby certify information s bgitted s correct and there are no other structures located on this property except
as shown.
f � �
Owner 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 The zone is "44"
Sewage Permit Number Issued Building Permit &/__* Receipt / 7 40 (w Issued
Remarks
Form A23 Rlda. Cede
10,
SO
op-
IILII E.
j>A,RCEL U-- bq5L4-Z- 111i
TOB gbh
PA
tor- 9L I C --.t4 T-00 -W—A,4