1978, 02-02 Permit App: M4770 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
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. 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.
9926 7
Name of Owner •..� : Address a 4, .tE /� �A Phone 9 2g- 7-17--
Architect Address
APPLICANT FILL IN BELOW THIS LINE
Phone
Engineer Address Phone
Contractor _ 4 j4 -f c' - Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number i yS4 / - d to d o -
i / r 3 J 11" /71 ? - .
DESCRIPTION OF WORK: New X Addition Remodel
Size of Lot //9 k it. -1- le '
1 z n ...L/ D., 9r< 'Dt-urC
StoriesLDimensions xG- ir -6.4'r 2Z --t..171 CkX/ci -1--/.04./.2Rooms 12_ (Full
Baths 2 Basement Foundation Const
_ , part, none
�l Type of1R/oofing
Moving Bldg, Zone �_ Fir one 3
12.'
Sewage System - Const-1
4y� -
s i Fr., Conc., Br., etc.)
Total Sq. Ft 2.0 1/ Valuation 44dfd�d
Chimney 11r place
(Kind) urgber nJ
Int. Wall Finish
No. of Units Bedrooms
Heat. System
Use of Bldg.
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 acd streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
ue
NORTH
SOUTH
I he eb certi y information submits
as shown.
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE
THIS IS NOT A PERMIT.
O7t
correct
and there
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State License No.
Ind. Ins. Acct. No.
(RESIDENT( - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
X60-3
are *other other structures located on this property except
Date
PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
47° /
Your street address will be �Sp� "y�, ��Q //�►//I , The zone is CZ9%tci.dt,I -17,
Sewage Permit Number Issued Building Permit l� ' Receipt /5'SJ5 Issued
Remarks C14.. ( - RANCit AA'A ' � RAN � Vi�f jol
Form 523 Bldg. Code
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