1977, 04-04 Permit App: M0759 ResidenceCounty of Spokane. Washington
Basic Job # 121
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE.$_4$.,,Q4
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 Stat
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 Rohart p_ T,nrg Address E. 11927 — 25th Phone 924-4782
Architect Address Phone
Engineer Address Phone
Contractor Same Address Phone
Legal Description of Property (Give complete description from deed. tax receipt etc 1
Parcel # 20543-9027
Lot # 18. Blk. 6 Sherwood Forest
DESCRIPTION OF WORK: New X Addition Remodel Moving Bldg. Zone —1— Fire Zone 3
Size of Lot 657227130x140x115 Sewage System Sep Tank Const. Frame
(Fr., Conc., Br., etc.)
Stories.,L_Dimensions 24748, 301(22 Total Sq Ft 18121}�Valuation
$52.500.00
Rooms 5 Baths 2 Basement 711111 Foundation Const Concrete chimney''�asonrYireplace 2
(Full, part, none( (Kind) (Number
Heat. System P p F;1 en Type of Roofing Shake Ext. Finish T1-11, hap Int Wall Finish Sheet Rock
Use of Bldg. Rami (tan na wi th attached garage
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
pro•.=ed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
and water supply lines.
RESIDENTIAL — COMMERCIAL
No of Units 1 Bedrooms 3.
NORTH
See Attached plot plan
I hereb
as shown.
SOUTH
State License No.
LO—NG—*R—A246R0
Ind. Ins. Acct. No.
327-551
REQUIRED
Plumbing Permit
rn Heating Permit
.Sewage Permit
y
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
tify iiiiformat4on submi is correct and there are no other structures located on this operty except
et/5i
Owner or Age Date
A LAND E OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS 0 ' PERM .
DO NOT WRITE BE1OW THIS LINE
^7�t
Your street address will be .. CV t.2? ;> u„ C.\ga.iiiThe zone is 'ts.
Sewage Permit Number
Remarks
Issued
Building Permit'fIQ 7,Sc ReceiptrT tJ Issued
Form 523 Bldg. Code
LOT /B, BLit. to
.51/ERlitmaJ FOREST
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