1977, 02-22 Permit App: M4968 ResidenceIP
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 47 /„O-
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APPLICATION
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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 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 Office.
SEWAGE SYSTEMA. 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 OP 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
�,l,/" -/I- ( alis _479zo7
Name of Owner, �l .(AAA'23.d (11.- H dr. Address
.�./ _....� _ ...iI phone -7 .�.1-/O 4g
Architect \ GG Address Phone
Engineer{{�� Address Phone
Contractor rte`/{ iv .O - Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number /7 3.'S 4/ -
.�zoS
o r S /5'L/f / CJ/_ez.i. uA04.f L¢c oLyCj
ROADWAY R/W WIDT{t So
DESCRIPTION OF WORK: New X, Addition Remodel Moving
New,
Size of Lot RSA" / 3 6 A PP • Sewage System
Stories --Dimensions e2/ X3/ -f .2 42. X 2.2 7- /DX /2
Basement Total Sq Ft /J`e't O
B�ldp. Zo!p _/ Fire4one .l
(Fr., Conc., Br.. etc.) jO
luation 4/160.0--
ireplace
(Number
Rooms S� Baths / , PO . Foundation Const. t-o�r,C�' (� Chimney
(Full. part, none) y (K/ ind)
m 0./' i /F/� ¢ T�y pe oRoofing _r Ext. Finish Int Wall Fini
.d .L.Q3iGC•CRi Zen., l{APf� No of Units _Bedroo s ?
Heat. Syste C �Yl t
Use of Bldg. ,fl
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
gs NORTH
sh
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
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SOU TH-
State License No.
OK OA(
Ind. Ins. Acct. No.
/D -28-7g
(RESIDENTI j- COMMERCIAL
REQUIRED
Plumbing Permit
rw Heating Permit
Sewage Permit
- 4
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.
.72
Owner or ntDate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
(9AC, "1414 to 0) DO NOT WRITE BELOW THIS L NE ,
Your street address will be F / S/Zj .4.M� /`A �7 /, The zone is�/,[-flLCI 54_sC�.FC,I'R,
Sewage Permit Number Issued Building Permit �rI Receipt A 2%i A% Is/sued
Remarks
Form 523 Bldg. Code