1977, 04-06 Permit App: M1109 Residence•
County of Spokane, Washington
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BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 mO
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
ii PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
r1 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.
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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 the structure 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 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 TPIS LINE
,,,Cr 1 <X 7)--) Phone -7 72- 3 �
1
Name of Owner
Architect
7,-)1-41
Engineer
Contractor
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Address
Address ff 777 J /1/ L 177/,_-_.‘i Phone
Address L D /9. j 7p;oi Phone
Address Phone
Legal Description of Property (Give complete description rom deed, tax receipt, etc. Parcel Number
/2v✓'O,v .z. ST'
/0,,�T,c,✓ �;f jq2<f/— 7L2�
DESCRIPTION OF WORK: New
Size of Lot / -' 3 /
/, >" L C C /
Stories Dimensions
Addition
L/ G,
5 lG /f'/ L /
Remodel
Moving Bldg. Zone Fire Zone
Sewage System � 4-ve r G Const. /��
, etc.) ��
Fr., ConcBr.
Total Sq Ft /C1-2 1 Valuation ///i/' Z' o 0
Rooms Baths Basement it, 1/ Foundation Const
C Fu I, part, none''
Heat. Systst em , C, 7-7, Type of Roofing ,-1-/-/-/3 E.
Use of Bldg. c /;-/ E Ge.) n.4 G /71 f- 0
4,0
v c/C T Chimney Fireplace
Kind) -/� (Number
Int. Wall Finish ;22 % GU r-?- //
No. of Units Bedrooms g
Ext. Finish /,!.)
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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.
NORTH
SOUTH
I hereby certify infortsa'tion sub
as shown.
Owner or Agent
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State License No.
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit //1 c /✓� �/C,=
Sewage Permit (-/
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
tted is correct and there are no other structures located on this property except
l.�rvf �,I1
Date
/- 17
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
6A -L, '2,4/1(461,4E?
Tour street address will be /44 / %f
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW THIS LINE
The zone is )2.1z1/4
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Building Permit //d7 Receipt " Issued
Form 523 Bldg. Code
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