1977, 11-17 Permit App: M4169 AdditionCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON ' 99201
APPLICATION FOR LAND USE OR STRUCTURE. PERMIT Ca 4
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required byCounty 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 onwater '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 47235.
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 thestructure 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.
AP LICANT FILL IN BELO - THIS LINE
7
79.z2W
Name of Owner < .. / ,, ‘ " _. Address Phone 9A e7-4-3'73
Architect d Address Phone
Engineer Address Phone
Contractor
Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number 0775-44— / /O 9'
c d -_--x `7yt 72 t,./Y -sizt
DESCRIPTION OF WORK: NewO Addition / Remodel Moving Bldg. Zone / Fire Zone 3
Size of Lot O.S �)( / Sin Sewage System (Fr., Con B t )
Stories _Dimensions/
Rooms _ Baths Basement Foundation Const Chimney Fireplace
Fu 1, part, none (Kind) (Number
Heat. System u-c-a-ce- Type of Roofing ` - Ext. Finish Int Wall Finish
U - : of Bldg. 4 ��i T. _c_..„, r « .G2 No of Units Bedrooms
PLOT PLAN
Draw s:T3 ch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed bu dings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
Br
a c.
Total Sq Ft Valuation o0
NORTH
SOUTH
State License No.
Ind. Ins. Acct. No.
RESIDENTI -COMMERCIAL
REQUIRED
Plumbing Permit
rw Heating Permit
Sewage Permit
-I
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify, information sub ed is correct and there are no other structures located on this property except
as showp;
Owner or Agent O ate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
'DO NO WRITE BELOW THIS LINE
est
Tour
Tour street address will be / // - The zone is
Sewage Permit Number Issued Building Permit N Receipt
Remarks
Form _s23