1977, 09-19 Permit App: M3383 AdditionCounty of S okane, Washington
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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 mast 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 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 ,� -2p�
Name of Owner ' Address
Architect Address
Engineer Address
Contractor AA'IeC- Address
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
S�7t�p Phone W A-44-6 9,1-
Phone
,SPhone
Phone
Phone
Parcel Number 074-2--/aD
DESCRIPTION OF WO�JiK: New Addition �_ Remodel Moving B;dg, Zone _L— Fire ne _
Size of Lot _�4 x / D C1 Sewage Systemjj� Const.
Fr., Conc., Br., etc.)
Stories Dimensions X Total Sq. Ft. Valuation V d
Rooms Baths AIA
(Full, part ent� ZA Foundation Const.. Chimney �N
_ Fireplace
(Kind) (Num er
Heat. System Type of oofing E/xt. in sh Int. Wall Finish
Use of Bldg. Q &i6� - - 2lLd /at' p d_ -- 1� �! f! - No. of Units_
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.
NORTH
SOUTH
State License No.
Ind. Ins. Acct. No.
SIDENTIAL L COMMERCIAL
REQUIRED
Plumbing Permit
M Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby cer fy informa� submitted is ect and there are no other structures located on this property except
as shown. it r __ e „!i% c1 — / r/ — 7 7
Owner t 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
Your street address will be if -76---7 3u 3 The zone is
Sewage Permit Number Issued Building Permit Receipt 221L Issued
Remarks
Form 523 Bldq. Code
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CERTIFICATE 0'1' SUR'VZY
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I certify the mapshone above shows the are;a,`boundary and location of the
!-, w 54' of E 342' of S 1097"' of N 132' of Tra--t 12, Electric Railway Suburban
Home ��Addition and the improvements lobated thereon as determined
_r by actual field survey and there are no ove:r'l.aps or encroachments except as noted.
Seattle FIprat Fational Bank =
Millwood, jWashington .'
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' .7522 E. 140rietta
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562-025
. Rc,?t
C rence E. Simpson
Civil Engineer & L s. -
�` North 909 Argonne Road i
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�, kerne , Wa sh ine 99?Oo--
.+y.+'r' Spo
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