1977, 10-07 Permit App: M3666 Roof Line0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE ./6 -----
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 most 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 47235.
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.
Name of Owner
Architect
Engineer
APPLICANT FILL IN BELOW THIS LINE
:•
Address �wc-=-- �Phone J � 3 '.?2s
Address //'t en :• Phone
Address Phone
Contractor ,4.04n..> Address Phone ,J�
Leg cription of Propert Gi/v�e--yw�(mp ete/�/deescription from d, tax receipt, etc.) rcel Number 0 .' — 0 G
Ctir/ (���t YY�_) v3/� r7�� 2' 7 . Ass 1J ' 4 y 97 67'
2, (,)3,,�' /r, en',/ c4 t_n
DESCRIPTION OF WORK: New Addition Remodel
Size of Lot fO'Y3/3- 't- ijl'_' /.C74 '
Stories / Dimensions 4(6 /'LSC �/s,�
Rooms Baths Basement Foundation ns
Moving Bldg. one __ Fire one
Sewage System Cons
Fr., Br., etc.) orb/
Total Sq Ft valu ti <3 To --
Chimney (Kind) Fireplace
(Number
Int Wall Finish
No of Units _Bedrooms
V
Fu I, part, none)
Heat. System
Type of Roofing
Use of Bldg.
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.
NORTH
SOUTH
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
nw Heating Permit
Tv
Sewage Permit
-I
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.
/1-42.0 kenTl th /0 - 7- 77
(J 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 BE,OW THIS LINE
Your street address will be / (p a O
Sewage Permit Number Issued
Remarks
Building Permit
2/
-11°‘The zone 1s
L.4
c
Rene 1ptai/O.�! ssued
Form 523 Bldg. Code