1977, 04-22 Permit App: M0766 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMITc,
GENERAL REQUIREMENTS PERMIT FEE �d
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 mast 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. 7
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235. +,,
SET -RACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of tat
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 Read 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
Narne'of Owner 5.4n7 e
Address Phone
Architect Address Phone
Engineer Address 99%20 6 Phone L--
Contract • ..• . - Ai. Address / 9. /10 s o . b A v f'd phone 5--3 V `' 7 / J
•
Legal Description of Property (Give comple e description from deed, tax receipt, etc.) Parcel Number it 02,5-14-5.2- //Da
L. o r c igLA' 4 7Ja YJe av- AQ#t tit
DESCRIPTION OF WORK: New ` Addition
Size of Lot /O O ' X / 3 J
Remodel
Stories .L Dimensions OP !s k S 2
Rooms Baths P Basement/4-
61/7 Foundation
(Full, part, none)
Heat. System E/eC Type of Roofing ' Cni./7
Use of Bldg. Re S. 0 C it e.2.GS-
Moving Bldg. Zone / Fire Zone .3
Sewage System < eprte onst. F2
(Fr., Conc.,�Br., etc.)
Total Sq. Ft. %%?9(KValuation �e/ OCG
Const C0ai7c' RrT e /`mbChimneyQ !C Fireplace
ind) // 7 (Number
Int Wall Finish SAeQGk
Ext. Finish A 4p
,r) A'5 &- , i Emu Y No of Units LBedrooms 2
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.
nu
N
-I
NORTH
Ss' >
N
14)
SOUTH
State License No.
C23 -o/-24/5'5-7
Ind. Ins. Acct. No.
3--22-9cg.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify info submitter torr:, t and there are no other structures located on this property except
as shown. Z
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street ad4Oesa will be / / 2
Sewage Permit Number Issued
Remarks
Z. O ke k i The zone Se Sin9LC A=/SaC 1
Building Permit rn6 76c Receipt Issued /
7
Form 523 Bldg. Code