1977, 04-06 Permit App: M1105 Residence0 0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR 'STRUCTURE PERMIT 60�
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of ay
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 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.
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1 cour ry ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
perfe7-Amed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer. r t;
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 / ' .' Address ,4 -? /-/i r /.�.%� Phone 77.7 -
Architect Address !7� AEAA, Phone
Engineer - Address f? -Y -2C Phone
Contractor .7'77 f Address Phone
Legal Description of Property (Give_complete description from deed. tax receipt. etc.) Parcel Number
l
Z01 7 /o G,U o 7Gy/=o G/) 11
/ / 25/CV — 'oz (57
r -J.
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone / Fire Zone 3
Size of Lot /S X 3-2
/> /CE /E-/
gait-
/ Dimetnsions a !' X I �P /
Rooms Baths �( Basement Fac // Foundation( - Const (7-v ,/r iP rrt
Heat. System F. ,Ci 4 Type of Roofing —),UL? N/! Ext Finish bin&
Sewage System tipz+� Const. tp AihG -
d (Fr., Conc.,, Br..Br..etc.)
Total Sq Ft ____m;.Z Valuation 7/ /J///r
Fu I, part, none)
Use of Bldg. from < /e//�/,G/1�,Qt) FQ 9-ia,t'.,4 �i C
PLOT PLAN
Chimney . Fireplace
(Kind) (Number
Int Wall Finish �//je J Gf) 7/
No of Units Bedrooms r
Draw sketch with dimensions showing: (I) 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
/2777:94--,-/ id
SOUTH
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State License No.
n K.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit C4T
Heating Permit //1/) EA/AO/Gi-
Sewage Permit l / ,¢S
y
Plans Received
Plans Checked
Plans Returned
Flans Picked Up
Plans Mailed
I hereby certify information su itted is correct and there are no other structures located on this property except
as shown. / r
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
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Iour street address will be /2 /g a, "J 14-'x/ tQ�i•
Ate zone �Ser(�{,/�l/J-U'A.f i/!d - -'^^'-
Sewage Permit Number Issued Building Permit M//Q (' Receipt n �7 !el Issued
Remarks / •'
DO NOT WRITE BELOW THIS LINE
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Form 523 Bldg. Code
C7.7 -17.C17
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