1977, 11-01 Permit App: M3979 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
PERIMIT 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 land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
56,g°-
APPLICANT
6%
APPLICANT FILL IN BELOW THIS LINE
Name of Owner i C edress
Architect Address
ess
Arch
J' � Address
Contractor // 67.0,1 C .1.641_0. 4•'Q�it Address
Legal Description of Property ( ive complete description from dead, tax receipt, etrF 1• p6rcel NurBbefr,
.Lt1992J10
//. Phone7e-/ VS c/
Phone
Phone
J l�y
J 2 3 ,'""xei'4/1;74' Phone
'ZP /y .r9
DESCRIPTION OF WORK: Ne L/ Addition Remodel
Size of Lot /•7 5 J • ASO AJ 9
Moving
Stories .L Dimensions
Rooms Baths
Heat. System
Use of Bldg.
irt, none
Basement Foundation Const
ype of Roofing
Draw sketch with
proposed buildings;
tem and water supply
m
cn
Bld9ne / Fire Z S
Sewage System /.4 r✓� Const. h a2 A. 'L.'
(Fr., Conc., Br., etc.)
L
Totgl Sq. Ft. Valuation alJ 17
d .c, e tfi jL Chimney Kind) Aviirg�ilac
(Number1.1
Int. Wall Finis9 10,44 / (le 1/
i,( No. of Units LBedrooms 3
cat
PLOT PLAN
dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
(4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
lines.
NORTH
SOUTH
Stat e ee No.
i
Ind. Ino Acct. No.
OK
CESIDENTI — COMMERCIAL
REQUIRED
Plumbing Permit
w� Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby c rtify information submitted is cor t and there are no other structures located on this property except
as shown. C ���J /
Owner or 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
i�ttir ?2�a� ' )
Your street address will be i �. „� 3 e zone isJi, f-Q/lik(
Sewage Permit Number Issued Building Permit Receipt 7./Y/ Issued
Remarks
Form 523 Bldg. Code