1977, 06-22 Permit App: M2125 ResidenceSpokane, of Sp , Waston 9
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS
PERMIT FEE
PERMIT rEQaltnlistructure
scdyucResolution
erect
building
structure
the
kind
or teraybulding orstructurealreadyereted ortohangealand use.Constructionmast conform with
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.
leastSET-BACK k
25'FisMrequired, al 5' side yard,Zones and 15' side yarrdrfromtacflankingnstreet,sandbac25' rearthe
yardfront
areprequiredrty line, of at
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
and egress.
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.
AP'LICANT FILL IN BELOW THI UNE
Addres - , AI • Phone
Address Phone
Address Phone
Address Phone
4iC 0-6
Name of Owner
Architect
Engineer
Contractor
Legal gescri tion of Prope (Give complete description rom deed, tax receipt, etc
DESCRIPTION OF WORK: New X Addition Remodel ing Bld
Size of Lot
Stories
Rooms 47
qz2. sv / x ci9
M
Sewage System
n
DimensionsaF�X 02..c/ /4"c20 IX �{�/ IX 4/ Total Sq. Ft f 7 9
`3✓lnn�x
Baths p7 Basement p -'Foundation Const.
Ext. Finish
( ull, part, non
_Type o oofing
rL/,cusLLsr►7-"
PLOT PLAN
Draw sketch with proposed buildings;dimensions showing: property lines; (2)
(4)distanceto property linesandstree
tem and water supply lines.
NORTH
R4tyrl,� t"v
Heat. System
Use of Bldr_ w --'
m
n
Ch i mne
Kind)
Fire
Const.
Fr., C c., a c.
Valuation
ireplace
(Number
er
Int. Wall Finish
No. of Units Bedroo
street or road locations; (3) location of existing and
dimensions of buildings; (6) location of sewage sys-
MMERCIAL
Gvo--L
a
n
.I
State License No.
_L3,d4/c 3-0
Ind. Ins. Acct. No.
REQUIRED
,,%
Plumbing Permit -Sal 4/-4 2
Heating Permit L�
Sewage Permit /(7le: 1,
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby ce tify infor ion submitted is correct and there are no other st ctures located on this property except
as shown. -' i)
Owner • :ent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
6/11-,14c4L12
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Tour street address will be ) , ��/L. ,k)2 wL.
Sewage Permit Number Issued Building Permit %11, / h RTheeceiptzone Issued
Remarks
DO NOT WRITE BELOW THIS LINE
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