1977, 04-06 Permit App: M1064 MHCatnty of Spokane, Wasliegton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
4214.
GENERAL REQUIREMENTS PERMIT FEE —fid
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 47235.
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 mast 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 9%2�(�
'Name of Owner CdVdG-t GU V rel Address 9a0% s' 77r'af Phone 919t -06o o
4
'Name
/ Address Phone
Engineer Address Phone
Contractor �a-nZ-a— Address Phone
Lee9.al Descyiption of Propertyyd�lc� iveeL complete descriptionptrpmrdeed, tax receipt etc ) � '9� � '^
IVaVt/r•et P70&ho. >A me 1 /d,r O-7$5-/ — 04/O
DESCRIPTION OF WORK: New Addition Remodel
/10
mensions /� 10
Size of Lot
Stories
Rooms
Moving Bld Zon / Fire ZZZoonee`++'`3
Sewage System 9111:2Y
y [L( (Fr., ConC Br.. etc.)
Total Sq Ft 7 ":,/ Valuation �nO 0
Baths Full, pain, nonef Foundation//Const 3�'t1�/��j
Heat. System E/C Typ{gg. yo Roofing /`/ '7' -/ Ext
finish
Use of Bldg. fiat! P /Mina cZ JCe.0/Ile
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.
Chimney Fireplace
(Kind) n ' (plyimber
Int Wall Finish
No of Units Bedrooms .2.—
I,SOUTH
submitted is correct and there are no other structures located on this property except
as shown. I hereby certify in t !�_ 6 -77
L
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCE .
THIS IS NOT A PERMIT.
Oil )4 DO NOT WRITE BELOW THIS LINE
NORTH RESIDENTIAL — COMMERCIAL
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State Lipenee No.
Ind. Ine. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
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Your street address will be /9516.
a5 6 /`LO7Y/ 1l G'W
Sewage Permit Number Issued
Remarks
The zone is
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Building Permit if Io 0- $O
Receipt �'Issued
Form 523 Bldg: Code
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