1977, 03-29 Permit App: M0210 ResidenceCanty of Spokane, WasI9ton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
g Pi-
GENERAL REQUIREMENTS
PERMIT FEE
PERMIT rEQalternliuse or stpscyucty gesallnto erect
nor re of the
kind
oer any building orstrucurealreadyereted, orto chananduse. Constructionmust conform with
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water shoulssorbditches approved County Rooaads, permissionHealth
must beDepartments.
obtained fromre thework
Countyater Engineer's Office.
disturbs
the surface, shoulders
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SeastAFisMrequired, al 5' side zones and
side yardrfrrost om acflankingnces, a street,sandback 25' rearthe
yardfront
areprequiredrty line, of at
leastTE 25'clearance must be obtained pertaining to set -back and ingress
- STATE HIGHWAYS. Where the structure abuts a State Highway,
COUNTY Oi
nSstreet
of-way may iperformed
staked
County
Road
trii work trtnst be
"'rand egress.
performed accordancewith stakes.Points of ngressandegressmustbeapproved bythe CounyEngneer
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.
whichlareVenforce enforceable throughBuilders
civiluld check action. CountysOfficialscovenants
not bringdedications
toand
enforcements covenantsing with the land
or dedications.
',61X6
APPLICANT FILL IN BELOW THIS LINE
Name of Owner �, r r ' ' ^ Address
Address
Architect
Address
Engineer Address
Contractor
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
"
t .)J
L , ,f /) i i, K Jr ,1 �,�,
Cc_ „ (=Jr; Phone /' f / i" F
Phone
Phone
Phone
—
DESCRIPTION OF WORK:�e�-' Addition
Size of Lot P. x /C4. 7ti k
-)Cx12X aux:3 /DX/a.
Storie1/
Dimensions 5E X 3 Y
Rooms _ Baths Basement (,h, -t Foundation Const..
Fu I, part, none)
Heat. System r A 1,:1‹,1 Type of Roofing . > /j, ii .- . Ext. Finish -'- ,,
'- f 11-4,11, I},/
Remodel
4, L y .:✓ % X �i, 2, i/
MovingBldg. Zone / Fire Zone
Sewage System J
,c, ,,.3 6 (Fr.,
Conc., Br., etc.)
Total Sq. Ft — Valuation `- `,..) t it
ind) Fireplace(Number
Int. Wall Finish 1-.'f1
No. of Units i Bedrooms
Use of Bldg.
.a I.
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
NORTH
2(
Chimne
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
RESIDENTIAL — COMMERCIAL
I hereby cy infor
as shown.
SOUTH
o. submitte
State Licce/ns No.
k �
77
Ino. Ins. Acct.No.
REQUIRED
Plumbing Permit
1-n Heating Permit
a Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other structures located on this property except
A LAND U
THIS IS N
Owner or Agent Date
OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
T 4PERMIT.
DO NOT r RITE BELOW THIS LINE
If
Tour street address will be
Sewage Permit Number
Remarks
Issued
Build
e zone
g Permit _r fr Receipt` 1f 9 ued
��''�a''11 ��
PORITICIUNITIMPRMS.
General Contradore
4111040,0100.11.111,111~011.00
PHONIC saaa.106a OPOKANII. WASH. 3I�
109.5..!•
- /RI -
10'
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