1977, 02-28 Permit App: L7199 Residence-Ccanty of Spokane, Was agt®n
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT S
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 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 -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.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner r �� �iJ4. 7. > I. Address
Phone !#a{'R ggs)
Architect Address '1 rctL.lts,(, Phone
Engineer Address N Phone
Contractor V.R NNP Address Phone
Legal Description of Property (Give conxelete description from deed, tax receipt, etc.) A2,,4r10- PV RT 9 '13.543 ads: At
(. 0 7- 7 /31-K, cs- 15;4e -et NO ad/LAC& /.tom azid
DESCRIPTION OF W9RK: New >— Addition Remodel Moving 81y4 Zone / Fire Zone
Size of Lot ,6 o V. i ,) - Sewage System,XJ "-Pt C., Const.*rf -'%
t ) (Fr.. Conc., Br., etc.) 6 0
Stories* Dimensions 30 x6-6 4- 2-#)t G r /OX it-. DEC -t( Total Sq Ft aQ.>2 Valuation C -a g60
Rooms 4 Baths J Basement gulf Foundation Const eNti�' � "" ' '1tb t
1 Chimney FiieplaceNumber Kh
(Full, part, none (Kind) ,9 (Number
Heat. System Type of Roofing ...a1/4.41.4,,k-e. �..�" p Ext Finish 7---// I Int Wall Finish N f '.*.t/O
Use of Bldg. �{ .tbd L/��i.L.C'P,-i-rkei.? Ck_r Remit A No of Units _Bedrooms -3
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.
0
-1
NORTH
RESIDENTIAL - COMMERCIAL
State License No.
GK OA/ ,C/t.6
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby cer ify rnforma on submitte
d is CO t and there are no other structures located on this property except
as shown.) 7 7
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(9-M, -m.W
DO NOT WRITE BELOW THIS LINE
Your street address will bet•/.2 .� 1Cj, t,I41.-�Q .///��, /// The zone is aA _&.-. tir/�t--lite.,
Sewage Permit Number Issued Building Permit t7�'71 yf Receipt 4•t/�'S Issued
Remarks •
Form 523 Bldg. Code