1977, 12-27 Permit App: M4491 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT_ 5
GENERAL REQUIREMENTS PERMIT FEE C/
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. Rater 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 tbestructure 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 must be
performed 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.
,J7 J Y� APPLICANT FILL IN BELOW THISt�LINE
Name of Owner /l a cf_ . F? U Address a o �r z0 u "'Phos 5/v1 - W1S-/
Architect
Address
Phone
Engineer Address Phone
0 vrV,2 90 6G F67
7
Contractor � '" Address
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number
DESCRIPTION OF WO : New // Addition Remodel Bldg. Zon sZe Fire Z e
Size of Lot (r�' x x .. ..wage System .T P�J l�r�onst.
Moving
Stories / Dimensions x 3-0 ,) a Y 2 Y
Rooms Baths 2. Basementf��% Found tion
I, pert, none) �-/
Heat SystemFe C- f=i -Type of Roo ing !
r r., Con etc. o
X 0 Y/ o*toXr�'Total Sq Ft 42226 Valuation 7.S6GU
Const £5 tc-. - ChimneyrlR SOAIK I %✓
.2hc/�-Q. Ext Finish Int
nap ace
(Kind) ummber�/
Wall Finish /
Use of Bldg. .�aia . , .: lr��_ �� ��- =�- F -4rx4-0`0. � r Y '" No of Units _Bedrooms
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.
)"
N
NORTH
1,
1
etc
3D
S�
-e-
go Alc�� f'OSOUTHDfit /'�
I hereby certify information submitted is correc
as shown
State Lice se No.
Ind. Ins. Acct. No.
RESIDENTIAL
COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
re no other structures located on this property except
Date
A LAND USE OR STRUCTURE PE MIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
set address will be r //2.23 PQN I�( 0 sa-n (✓I, The zone is
.Sewage Permit Number Issued Building Permit 4/1 Receipt /C P
Remarks
Form 523 Bldg. Coda