1977, 04-19 Permit App: M0711 Residence N
Ci infy of Spokane, Washogton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT / -C3
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GENERAL REQUIREMENTS PERMIT FEE1
PERMIT REQUIRED. A land use oro structure permit is required by County Resolution to erecta building or structure of any
Lnd or alter any building or structure already erected, or to change a land use. Construction mast conform with the
Vokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
ATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
he 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 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 THIS LINE
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Name of Owner i Address , 7G --/- / ii ,71/L..,c( Phone 1/dy�•?2/j
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Architect Address Phone
Engineer Address Phone
Contractor ' ' +.
r •. Address S •za-/ e Phone 514 rh P
Legal Description f pryea(Give cornllletg description fro deed, tax re , etc.)
i"zr f"- �c? vJ ! e c� 7`•/L''/ s7 Alj' / r a .S .1 C .S -
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg./Zone Fire Zone =J
Size.of Lot Lt .- _ > ,
1 Sewage System �. (Fr., Cc�r}c B .�etc.)
St ries Dimensi s 3 2. Total Sq. Ft. . O 4 'Cf
� Valuation Fireplace_e-s , _ th
Rooms • Baths �� Basement �S Foundation Const.. C--dh crn r`f�l(C-
(F II, part, none11 �Chimney
rr,' -�� J (Kind) y� (Number„
Heat. System Cc J Type of oofing Sk'4 e...5 Ext. Finish J "' / L / Int. Wall Finish 1//)i At' F,�
Use of Bldg. e'.S J dePI ri e6/ Car'df,e l,C•-ldt-r ADs'1n No. of Units Bedrooms 3
!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-
te nd water supply lines.
(j NORTH gESIDENTIAL.S COMMERCIAL State License No.
Ind. Ins. Acct. No.
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AJ ' �h« f
REQUIRED
Plumbing Permit Ft.1-5-- - A
in Heating Permit Si» . )111
m a g
a H Sewage Permit ,/t e/ 1,11 I/('r ,P
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Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I heect and there are no other structures located on this property exc t
as Shown.reby certif information submitted is correct
- , 19 A ,i / /17 -2
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
el-} 2 ---;72 lq DO NOT WRITE BELOW THIS LINE
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Your street address will' be �7 / C " ";f/ f�'jG� �� The zone is o
Sewage Permit Number Issued Bu'lding PermitReceipt "7 7 5 Issued
Remarks ' .
Form 523 Bldg. Code
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