1977, 07-22 Permit App: M2504 Repair Fire Damage• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMI
GENERAL REQUIREMENTS PERMIT FE
j cry
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.
TATER. 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.
APP ICANT FILL IN BELOW THIS LINE_
Name of 0 I AC I ' I ' / . Address -CL'if�e 14L. Phone
Architect Address�J I7' Phone
Engineer �+ Address p/ D ✓ Phone
Contractor�4 �ueQ Address. %0$A/ ,RpPhos av7
Legal Description of Property (Give complet scription from deed, tax receipt, etc.) Parcel Number t J ps y- a3c)
DESCRIPTION OF WORK: New Addition
Size of Lot ?S/(Oar
Rooms & Baths I' Basemen Foundation Const
Fu 1. part, no
Heat. System - Type
Use of Bldg.../t/ •
Stories Dimensions
Remodel - (i Moving
Sewage System
one Fire
Const
Fonr.,
Total Sq Ft /_YT Valuati
Chimney
iYA
(Kind) (Number
Ext Finish Int Wall 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.
No of Units .Bedrooms
NORTH
SOUTH
I hereby certify igformation ted is correct and
as shown. �l
Owner
/14'7 gent
w
N
N
there are no other
State License No. t
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located, on this property except
Date
2/?- 7/> 2
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE THIS LINE
Your street address will be
Sewage Permit NumberIssued Building
Remarks
The zone is <
iG /Receipt 6317 Issued
Form 523 Bldg. Code