1977, 04-06 Permit App: M1725 Residencea . 1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 9920
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 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 thestructure abuts a State Highway, clearance must be obtained pertaining to set -back and actress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work,must�be
o .h=tiCormed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer. - - '�
MOVING OP 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
Architect Address .1.47 4 (n. J( 'c sr", -,),7 Phone
Engineer Address / I-- ? -!.0 Phone
Address Phone
Address t ,7 410 r /? P Phone 77-9-
Contractor ` Pin ei
Legal Description ofProperty (Give�/complete description from deed,��/(axySS�,,ee-c�e/1/�pt e_tc�.)�/parc/gaI ,Number
C o r / !J /D cfC rC /i\ .O�(�i� i/Y'1'[-L- (NNW �.
7s1nrr/ 2o?ysy'3—/J-70
DESCRIPTION OF WORK: New J: Addition Remodel
Size of Lot /S X 3O&'
Sp /; r. FNrr2, - to - k /' '
Stories_Dimensi s 'o
Rooms k BathsBasement u// Foundation Const.
I Fu(l, part, none
Heat. System e. p-,72 % Type of Roofing dNAdF_ Ext Finish
Use of Bldg. //Pal E 4/ ,977-9G./21sA &,,e2-27 Ay F
/
Moving Bldg. Zone ..._/.._ Fire Zone - 3
Sewage System rY2r+c. onst. `�/h F�
' /r., Conc., Br., etc.) o�
Total Sq Ft 2d ? Valuation 4/3-00/
�/o n)(+.O,rrfi Chimney F,4,h,v Fireplace 2
(Kind) (Number
/420,2 Int Wall Finish -/)e/f /1-1 •47)%
No of Units 1Bedrooms
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.
um
tn
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NORTH
4977-,9 c -/e
SOUTH
s
N
State License No.
OK
Ind. Ins. Acct. No.
RESIDENTIAL – COMMERCIAL
REQUIRED
Plumbing Permit 7-71-7.–.17
Heating Permit /./074E A/AoC-r=-
Sewage Permit (rfi.2 Alit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information submitted is correct and there are no other structures located on this property except
Owner or Agent / Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT .4 PERMIT.
69[,14 ,6 f' DO NOT WRITE /BELOW THIS LINE
EYour street address will be /;TG, / p /, z , (a _.i -e i A Tie zone is y
t)Receipt g5N: Issued
as shown.
Sewage Permit Number Issued Building Permit
Remarks
Form ;523 Bldg. Code
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