1978, 02-17 Permit App: M4943 Residence-County. Spokane; of S okane; Wash gfon
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 4fracture 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 )ffice.
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-bact 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 TH
IS LINE
( °bL deagaL4 Address
LIgtr of(a. 1 IS Phone9. 3a5 7NName of Owner
Architect Address (757,26/ 4" Phone
Engineer Address Phone
Contractor Swm e Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
!'1-f- q/0 f�/o c Pr ss�� C
f ri2e,r ICt`_Q /al- Y^- :2 6 /p sc'a /� 0/
DESCRIPTION OF WORK: NewV 1, --Addition Remodel Moving Bldg. Zone / Fire Zone �-/
Size of Lot /..-L(I / 0 0 Sewage System .' Y'177,-1 Const Cr
been (Fr., Conc , Br., etc.)
Stories Dimensions /KPX .3y. -2.21l 7 < .21 X 2'1 /o y t t. Total Sq Ft fe3z Valuation 4.1 4, /)
1 f
Rooms i%r Baths Basement 4 -Foundation Const C�,C✓C :Fe Chimney Cil 2t1 Fireplace
` (Full, part, non ;, I lnd (Number
Heat. System Fier - - Type of Roofing C -Orn p - Ext1 Finish l7 - ,"Int Wall Finish Decf t'- l /
Use of Bldg. �- a. aek/ d� - - - o of Units Bedroomis -7
PLOT. PLAN
Draw sketc with d mensions-showing: (I) 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 w er supply lines.
NORTH
.2 2
ry
I hereby
as shown.
12o.' SOUTH G
State License No.
15 -t -r 14-c6 113i'7 0L,
Ind. Ins. Acct. No.
5'7 7/7Fl
REQUIRED
ti, Plumbing Permit
ry Heating Permit
E: Sewage Permit
NN
(n Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ertify img{t,'on submitted is correct and there are no other structures located on this
C'c infor
L h1LCt,
Owner or Agent
cv_/i7�7f
DaYe
operty except
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION CO MENCES.
THIS IS NOT A PERMIT.
B-ry
Your street ddress will be
Sewage Permit Number Issued Building Permit
Remarks
DO NOT WRITE BELOW THIS LINE
t // 4TR/
Form 523 Bldg. Code
The zone is
Receipt
Issue