1977, 11-14 Permit App: M4116 GarageJ.Jd X 1`5)-"(1
• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
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. 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 LI
Name of Owner �� �,4.a! /ice ��/ ddress I / `.�/ _ .r.. ` Phone
Architect / Address ��1 �p // Phone
Engineer �1 � o) Address Catt, ..1za, 9Pa ? hone
Contractor's -4) �/ (3�?lA -� Address ?' . �y 0�P-S3 5.
Legal
escription of Pro,erty (Give complete
1
tion from deed, t: p r> eipt, etc.) Parcel Num
r
Phone
9.) a -Ass/
DESCRIPTION OF WORK: New Addition
Size of Lot
6 X 63D'
Remodel Moving Bldg. / Fire • e
Sewage System //7
Fors
(Fonr., c., Br., etc.)
Stories _Dimensions Total Sq. Ft /,-20-1-) Valu tion 76779r)
Rooms _L_ Baths Basement /�/r. Fo ation Const
Fu I, part, none" Ieammig
Heat. System
Use of Bldg.
Type of Roofing Ext. Finish
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.
Chimney( in) Firep}�c (Ngmber
Int. Wall Finis /
No. of Units _Bedrooms
m
NORTH
I here
as shown.
SOUTH
State Licen Noy
)5/r4
nd. I s. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
cerify information submitted isdbrrect and there are no other structures located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOTiWRITE BELOW THIS LINE
Tour street address will be -727_6_613
Sewage Permit Number Issued Building Permit
Remarks
i//6
The zone is
Receipt Issued
V�
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/—ly— 77
Form 523 Bldg. Code