1979, 02-20 Permit App: N2010 RemodelCout of Spokane. Washin on
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99260
APPLICATION FOR LAND USE OR STRUCTURE PERMIT "59_
tei—
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. Con-
struction must have inspections.
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 is required. See current
Spokane County Zoning Ordinance for all required set -backs.
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 building (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
Address HCl
Name of Owner_
Architect
Engineer
Contractor}S.44 4i..Q _a Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number pr -N.„3" --5.53/43--9-,T
is e(. 3 .3.->zept-t wo.,0 `4.L/.41 tat: adze
2/41/.ureagel- D6
a Phone g.2- '`
A ^/'/-
Address_ Phone
Address Phone
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DESCRIPTION OF WORK. New _ Addition
Size of Lot / q /
Stories Dimensions 21. X3tn
Cr
Rooms. �_ Baths_/ BasementEll/ VI/
(Full, part. none)
Heat. System A 4 . Type of R � y
Use of Bldg. „g 4., �f-p /� n'� /
ROADWAY R/W WIDTH Al[' -d / A4,2f 411
Remodel
Moving Bldg. Zone / Fire Zone .�
Sewage System f�/-t2 (Fr.. ti -
/ Fr., Conc., Br., eta o a
Total Sq. Ft. 9'312 Valuation x "l D r7
[[1 F
Foundation Const Chimney AKind Fireplace u be
(Kind) I umbe
oofin 1-d ..ff/� Ext. Finish Int. Wall Finish L'a,//—
OiVLf and No. of Units Bedrooms /
P_r /,CQL
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.
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NORTH
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SOUTH
State License No.
//d�
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit -
m Heating Permit
NSewage Permit
-I
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
4'-2'/' 9 a
I h. eb cert ifs inf..,:.ion s.t•rtted i correct and there are no other structures located on this property except
as shown. /
—7
Owner or Agent Date
A LAND Ue OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES..
THIS IS NOTA PERMIT. PERMITS ARE NON-REFUNDABLE AND NON -TRANSFERABLE
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number Issued
Remarks
2
U�
Building Fermi
e zone 1s
Receipt 23/4_I
Form 323 bldr,. Cort.