1977, 10-03 Permit App: M3612 Remodel County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT OS
GENERAL REQUIREMENTS PERMIT FEE /t,.l
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. 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.
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 91037
Name of Owner 3ta11S LU (G(i,$ Address 1 Qa. S Sr'ee Phone 91.80.3007
Architect Address Phone
Engineer Address Phone
Contractor O W N. R Address Phone f
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Pa cel Number y sv 1 7 G 0/ V
714' ki1Sr ' . oFt14 �vi.'l�f o PIR 'f�{ o t �lyr af-
Sec. ?y rws s RPM'�,� u
DESCRIPTION OF WORT • New.�. • Addition . Remodel Moving Bldg. Zone / Fire e
Size of Lot / f4/ I.�F E '/ Sewage Systems I� Conas
Const
( out, Br., etc.)
Stories Dimensions 1 pZ X 1 7' £/— Total Sq. Ft.e� �/aluati a ��
Rooms 1 Baths' Basement �' Foundation Const. G6'tti'E-ta- Chimney Fireplace
��. // Fu I, part, none) / (Kind) (Number
t'i C�
Heat. System Type of Roofing 60 prriiff t. Finish C/ ifYP Int. Wall Finish 7�r; 4.440Use of Bldg. flit UOS/trt, C $i'PO1 T IX) R- F"Rtta.yiooM No. of Units Bedrooms ^1
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 State License No.
• Ind. Ins. Acct. No.
•
AC u,.. GCBs �_ 'ESIDENTIAL COMMERCIAL
a/^�} • - I IRED
6 Plumbing Permit
So 0m Heating Permit
a ..,��N Sewage Permit
41/4 Plans Received 44I_.A,)t
• Plans Checked .. [Y
• A Plans Returned
4 Plans Picked Up
300 Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown. — 3- 7 7
Owner or Agent Date
A LAND OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be ,tO2 5 zone iso
Sewage Permit Number Issued Building Permit 7//The
Receipt O2 Issued
Remarks
Form 523 Bldg. Code