1977, 05-27 Permit App: M1601 Poolfli
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT4pY
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. Nater 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 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 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 J_L`f Z/ ! S TQ I2 R { Address e• 7"/ A-th
PhoneJ'aY--IBC
Architect Address
SOA Phone
Engineer Address
Contractor .014-0-4.- /941-'4 .y - Address 6 ?o% Z
„,,,;s.f Phone r&X - ., ' V
Legal Descrip ion of Pr pert(Give complpt des i tion from deed, tax re pt, etc.) Parcel er a r3 / - .,1 Y t7 /
0444 a/cd 4 v 4 N/t iia LT /6. 1 Cxc, /jl,. _/Y,f; 9'
DESCRIPTION OF WORK: New Addition
Size of Lot /.6 r X /6V"
Storie if DimensionsA /G r ie
.32-
Room( Baths v Basement
/ I part, none
Heat. System Type of Roofing
Use of Bldg. .0e2t/LA-G®t
Remodel
Moving Bldg Zo et _.C— Fire
Sewage System l;-' ,� Const.
(Fr., Conc r., e(c.)
Chimney ind) Valuation' Fireplace
Foundation Const
Total Sq. Ft
Ext. Fini
r
PLOT PLAN
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.
Int. Wall Finish
No. of Units—Be rooms
NORTH
m
State License
CD—
Ind. Ins. Acct. No.
RESIDENTIAL - OMMERCIAL
REQUIRED
Plumbing Permit
rw Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify informat ons mitt is correct and the are o other struck s located on, isro rty except
Own. .0*
as SnOW
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEORE CON UCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Tour street address will be 7/e)/ S— ,
Sewage Permit Number Issued
Remarks
Building Permit
The zone i - .41`
/6 ti Receipt `l 3 Issued
Form 523 Bldg. Code