1977, 02-18 Permit App: L7213 MH+CSpokane, Washgton
�ty of
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEtto erect a building or
structure 7.0
of
PERMIT REQUIRED. A land use or structure permit is required by County Resolution
kind or alter
any
ldblding andZoningstructure
already Ordinance. Construction erected,
orotoichs geeate a landiuse. Construction must conform with
Spokane County Baui
heER Water
shoulders be
County Roads, permissionand State ealth must bepobtained work on
Officedisturbs
the surface,
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SeastA25 FROMPROPERTY
LINES. ' side zones and
side yardrfrom aost cflankingnces, a street,sandback from 25' rearhe yardont areproperty requiredline, of at
leastSTATE I' is required,clearance must be obtained pertaining to set -back and ingress
HIGHWAYS. Where the structure abuts a State Highway,
COUNTY dO
Work on
street
right-of-way
performed
staked
y Roa
Department
work must be
and egress.
performein acordancewith stakes.Poins of ngressandegressmustbeapproved bythe CotyEngneer.
MOVING
F ncNGS. Aeermit is to move an
existing
ltbuilding
tmoved on a County or State
ighy,clearaemust bobtainedfomthe County Engineerand/orStae HighwayDepartmen
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit. the land
whichIareVenforcle enforceable Buildersld check
CountysOfficialsof ocanants or not bringdactionntoand enforceeents covenantslng or dedications.
APPLICANT FILL IN BELOW THIS LINE
--.1"C-21:1.-A-'-')-11"--.1"C-21:1.-A-'-')-11" (ddress Phone
ddress _
Phone
:� C4Phone
,,�.2 ,, one
any
the
Name of Owner
Architect
Address
Engineer •,/)
Contractor u_ -.----i AddressC
Leg escriptign ofYroper (Give complete descrip on from deed,
taxr
e a ��'
DESCRIPTION OF WORK: • Addition
e
Size of Lot
Stories Dimensions
Rooms J( Baths -- Basement
(Full, part, none.
Heat. System c r � Tjpof e Roofing
Use of Bldg. �f--
Remodel
Movin
Sew
r-2. Lam. L
Foundation Connst.d_L:-
ct..f Ext. Finish
r
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.
9
age System„,
Bld
Tgt�y Sq.t.
Zone r Fire Z e
const.' d_s'
(Fr., Cone, Br.,c.).
Valuati
(;himney Fireplace
/ ( ind) (Number
et-- --. Int. Wall Finish L° ��-
/`7
'--.,-Z E' No. of Units _ Bedrooms =f
m
NORTH
L — COMMERCIAL
SOUTH
I hereby certify information submit
as shown.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
rw Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
d is correct and there are no other structures located on this property except
2—/'-77
er or Agent
A LAND USE OR R
UCTURE PERMIT MUST B
THIS IS NOT A PERMIT.
6 /
Your street address will be
Sewage Permit Number
Remarks
Date
N THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
Issued Buildi
The zone is / TIME-Ndf--- ,,
Receipt ''$a Issued
s�j
1
y -tx 74-1N.0.4-2
40-1- 7 fy,„ /. g