1977, 06-28 Permit App: M2155 Pool•
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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 onwater 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
Name of Owner frcl ,d- cRfri.Y/ R Cn/, ki
Architect
Engineer
Contractor/�
Legal D/¢¢¢¢ scrip ion of Property (Give complete description
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14Address
Address
Address
YrC' c (S : T n 4' P. �o •rAddress I' 0 /'1,b o /dlc7i
r/76CIS G
% Phhononee 1* /' r '7 y
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Phone
/� Phone 9l t -G ./C4
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f om deed, tax recpipt, et )i arpPel Number
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DESCRIPTION OF WORK: New Addition
Size of Lot 33 A X 6.3c
Remodel Moving Bldg. Zone Fir@,Zone p
Sewage System — onst. ✓.O .n • % -
/ (Fr., Conc.. Br.. etc.)
Stories _Dimensions /6-- ' L 3 g / John Sq Ft S_ q 6 valuation,o" 7S 0
Rooms _Bathe — Basement --Foundation Const ,--".._.__---0----.62- ^�-----Chimney Fireplace
(Full, part, none) (Kind) (Number
Int Wall Finish
No of Units Bedrooms
Heat. System Type of Roofing n
Use of Bldg.Ext Finish
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.
m
y
I hereby qer 2y informs
as shown. •
SOUTH
ed is correct and
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plana Mailed
there are no other structured located on this property except
it
2. mss}
Owner,4r Agent
to I
A LANG USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT .4 PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address v111 be ( / 740 6 nq-, �%t�'' �.....0 The i one is
Sewage Permit Number Issued /Building mit IN9
1
5< Receipt -,(7/Z_-? Issued
Remarks FGI
Form 523 Bldg. Code
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