1977, 05-04 Permit App: M1040 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 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 l'and
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 ../ .IS - f3,}4Rs Caws?. G O • Address E •• 1 70t, S pf LI& Phone CP -4- $beep
Aychitect Address Phone
Engineer ZI4 OuC1 4.4.1 QO&h'n W Address Phone
Contractor SA,AL J-( Cay d`S•.S Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number 1 SsaM w• a XXCI
VAQRey V riW 6t 4IS to .
L '1 'I 1 6wrMA.i ss
DESCRIPTIO OF WORK: New X Addition Remodel
Size ofLot('o( ) %1D x %ti$ zi 150
Moving Bldg. Zone / Fire Zone 3
Sewage System _sN!►k. T•Const. -fir *
(Fr., Conc., Br., etc.)
Total Sq. Ft.204�8Valuation 84.71Sed
Cowl&IL76, ChimneirlM-- ' Fireplace MazT^I
(Kind) it/umber
T •It1 Int. Wall Finish LJM CAM
Stories S.A Dimensions Ab le b2.
Rooms 7 Baths Basement Foundation Const.
Fu I, part, none
F.A." . Type of Roofing CWm? . Ext. Finish
S LAVE r
PLOT PLAN
Heat. System
Use of Bldg.
6 4 17iCt4d. �No. Uni sBedrooms �—
't 1P. 13.444 NA4J f
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 jre��(5) dimensions of buildings; (6) location of sewage sys-
tem and wgter supply lines.
m
ut
NORTH
I her
as shown.
SOUTH
ti ormation submitted is correct
and there
State License No.
C%
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
j44'c^44-e*7.%
Plumbing Permit
n� Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
are no other structures located on this property except
S— — 1 -
Owner of 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
Tour street address will be / 3 2 , //l �'�/� ,<< ( The zone is
Sewage Permit Number Issued Building Permit /Y1 (p qo Receipt q /0 Issued
Rebarks
Form 523 Bldg. Code
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