1977, 03-25 Permit App: M0112 Residencef
Amy of Spokane, WasI ton
P 9
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. 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.
APPLICANT FILL IN BELOW THIS LINE
y t oLQ.�/�f'.'_d
Name of Owner C� 'k.lr!�i 0., Ce -r3 -v -(t - - -) ? �[ZAddress 9�=�✓. 1' *> z�1-t -L Phone `C9
Architect Address Phone
Address Phone
Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc ) _,If.'I (- tl &,.n 51- 3 ",`Sa/--')
Engineer
Contractor
DESCRIPTION OF WORK: New X Addition
Size of Lot ' ) �. -7✓
Stori e:
Rooms
Dimensions 2 4%x L ✓ j
- Baths / Basement u.l� (' Foundation Const.
4 -
(Full, part, none
Heat. System `rile 2� Type of(Roofing
Use of Bldg. A--',„0
Remodel
Moving
Sewage Syst
Bg. Zone —L Fire Zone .
em
(Fr., Conc., Br., etc.) p
Sq. Ft / Valuations l :5-4..% —
Chimney t'4"417j-1" Fireplace/-''./�Z
(Kind) n (NT ber„4
Int. Wall Finish � jYY/1 l��
No. of Units _ Bedrooms
fes,
✓�L
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
m
-1
NORTH
Total
Ext. Finish 7 -///
�f 6 C ,tta,f,IcL
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
<RESIDENTAL - COMMERCIAL
SOUTH
State License No.
/V -A/-G -L_2 i 13c
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information submitted is correct and there are no other structures
as shown. r.
_- 2, �,�,� ,„.yT �/ ., /7 -7
ner or Agent
located on this property except
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
0011! .IA- )1 DO NOT WRITE BELOW THIS LINE
Your street address will be ,SJ / �� �� X,/
Bilding Permit /(Sewage Permit Number Issued Reeeiot 1r" Gf
Remarks
Form 523 Bldg. Code
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