1977, 04-12 Permit App: M0810 ResidenceAntY Spokane, S okane, Was 9ton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT -r5/
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of n
kind or alter any building or structure already erected, or to change a land use. Construction must conform with t e
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 disturb/
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 Address
Architect Address
Engineer Address
Contractor
r - L- �1� Address
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l-Y._st S
Legal Desc iption of Pro erty ( i e completed cr pti from deed, tax recei
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frF/ yij. « ,Qq ;.-1,13 -n q/_s
etc l
, j� Phone —
Phone
Phone
Phone
DESCRIPTION OF WORK New
Size ofL t /L/J
stories Dimensi ns
Rooms 40 Baths lBa
Addition
Remodel
Heat. System
Use of Bldg.
�8(X3(.0
Moving Bldg. Zone / Fir Zon
Sewage System c9C-Pt
!Cd
(Fr.. (onc., Br., etc.) oo
Total Sq. Ft aluation
Chimney Fireplace
p �r�� /� (Kind) (Number'
Ext. Finish (Jli0VJ) Int. Wall Finish/ �r (.(41
No. of Units j Bedrooms
semens bi -
part, non
Type of Roofing
J J�/jl(
Foundation
Const t rine F
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
m
a
NORTH
F./T 9cc.
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines acd streets; (5) dimensions of buildings; (6) location of sewage sys-
ESIDE AL — COMMERCIAL
tchE_.D
SOUTH
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N
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information submitted is correct and there are no other structures
as shown.
,- 1)64 � / C )
Owner dr Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
(,4 , hz_i
4/iz h7
DO NOT WRITE BELOW THIS LINE
located on this property except
Date
CONSTRUCTION COMMENCES.
Your street address will be 42 A:5-;.20 ,� ,t,..�,�LF,,,L� �_ � 6
Sewage Permit Number Issued Building Permit -4 b'/6
The zone is �o...t
Receipt X 7i'z;4, Issued
Remarks
Form 523 Bldg. Code
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