1977, 05-03 Permit App: M1038 Addition• 0
County of Spokane, Washington.
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT - C -re
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 ■ork 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 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 25rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
i 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 G)Q/LO.o
%�
Name of Owner \ ani i�( ill l/tl Z Address /0Div- E, fD"A- Phone 9-2 "FOP
Architect / Address Phone
Engineer Address Phone
Contractor Address Phone -
Legal Description of Property (Give complete de cription from deed, tax receipt, etc.)
L.2 $3 "ss. DA) tits Sub,
Parcel Number
C83 -4,/y- o G,
DESCRIPTION OF CWOR�(: `New Addition Remodel /� Moving Bldg. Zone / Fire ZZoone J
Size of Lot rS JI 1i 5 Sewage System sem- Const. / �«+^ A,
2 '/ ���pp'� Fr., Con Br., etc.) ace
Stories Dimensions / 3- )( c /7 Total Sq Ft �j/QO Valuation -701513
Rooms 1 Baths Basement undation Const S �tM • Chimney �'�'-'� Fireplaaaccce
Fu I, part, none 11 Fin
HetSystem'
-.0,
y e of Roofing Ext Fini Int Wall Finish
Ude of Bldg. �} ��1� ��1/ ' _ • _ n if No of Units Bedrooms
(/ 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.
• NORTH
SOUTH
State License No.
p w.v,Er
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I herebltrtify informatiop'submitted is correct and there are no other structures located on this property except
as shown.
CL"nerOt
er or Agennt
5—:-7%
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
DO NOT WRITE BELOW THIS LINE
Y`CAIe,.LC� The zone is
Sewage Permit Number
Tour street address will be 7 00" Issued F Building Permit 74 /n,3q' Receipt 7047 'slued
Remarks
Form 523 Bldg. Code
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