1977, 04-08 Permit App: M2013 Residence•
County of Spokane, Washington
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 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 sin -face, 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.
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APPLICANT FILL IN BELOW THIS LINE
Name of Owner Mig iU 4VBr2WM . Address
Architect Address
Engineer
Contractor
Legal Description of Prope 11(a vve cgmplete 7C-6rCory f►pgdeep, tax recei t, etc.) a �eNSmber
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Phone
Address W.004, ✓ `c+
Phone
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' iea��Y�Q-� Address A �, i/Y/ .�one
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DESCRIPTION OF1 R New r Addition
Size of Lot / X ��� /
StSo/iTLIecoe (-36 'k �iQ�
ies / Dimensions
Rooms to Baths a Basement r� 11
1Full, part, none
Heat. System
Use of Bldg.
Type of Roofing
Remodel
Moving BId
-wage System
Sq Ft
Foundation Const (.1 rte.- (r Chimney
Ext. Finish It)OA C6
9ae49ta.
PLOT PLAN
Zone ,�— Fire one .
Const. .ne
(Fr., Conc.,Brr, etci)ed
Valuation
Fireplace -Q%- -
(Kind (NL ` belt/
Int. Wall Finish// DR 1 j� f
No. of Units 1. -Bedrooms
i2,77); -(?
T6, o
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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State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
/ SOUTH
I hereby certify ,J mation s itted is correct and there are no other structures located on this property except
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Owner or Agent 7
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
as shown.
4t 77
Date
(li..i -yi,. (q lir DO NOT WRITE BELOW THIS LINE
Tour street address will be 2, ,/,34.) j a, A,:p4..--k-tt: / !9_:
Sewage Permit Number Issued Building Permit
Remarks
The zone is (71.
Receipt h' 7(. Issued
Form 523 Blda. Code
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