1977, 03-31 Permit App: M0913 MH1
(
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.
WA . Water supply must be approved by the County and State Health Departments, Where work ou water connections disturbs
th surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
S AGE 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 rumina 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
Address Phone
Architect Address Phone
Engineer Address Phone
Contractor .,529» ^Q Address - Phone
Legal Descr tion of rogerty (Give co/iiriVtedescription.from,deed, description.from,deed, tax receipt, etc ) 20-7--
Ale,,/
O'i /1 /7/ /� J1 GCs'Cf�? ei
G --AL /� d/>i l r %fd rn C ,/'/a't . ' OG, er Y - //O- 7
DESCRIPTION OF WORK: New Addition
Size of Lot 7 7x t/3
Stories Dimensions /4/)(C C
Rooms Baths /
Remodel Moving Bldg. Zon Fire Zone
Sewage
System Con, (Fr., Conc., B//r., etc.)
Total Sq. Ft. 40?`f Valuation O-O•c O
Chimney Fireplace
(Kind) (Number
Ext Finish--yy Int Wall Finish
Q-5 chi_ ee 2'r'EC Ye'it Cre No of Units—Bedrooms Z
Basement Foundation Const
(Full, part, none
Heat. System Type ofZ2
coffing tale/
Use of Bldg. �) t / ,,
rpt•
3
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.
E
NORTH RESIDENTIAL — COMMERCIAL
ad% itsC
SOUTH
I hereby certifydefyof mation submitted is
as shown.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
Ye
N
Sewage Permit
y
Plans Received
Plans Checked
Plans Returned --
Plans Picked Up
Plans Mailed
correct and there are no other structures located on this property except
Owner or Agent
27—.9/- 7
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCE1.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
our street address will be ,%'J . y.2p >>/C.Acf{ The zone is
wage Permit Number Issued Building Permit
Re rks /g
X13
Receipt C/4,6". Isd
Form 523 Bide. Cede
/5-.0
2