1977, 09-20 Permit App: M3440 Residence C‘>int of Spokane,y p e. Wask.a>agton J/
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 yv
APPLICATION FOR LAND USE OR STRUCTURE PERMIT //)
C GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of ally
kind or alter any building or structure already erected, or to change a land use. Construction mast 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 CO ANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enf rceable through civil action. County Officials can not bring action to enforce covenants or dedications.
IdA)PPLICANT FILL IN BELOW THIS LINE
Name of Owner Address E• 9212 Montgomery, Suite one 3
Architect Address Phone
Engineer Address �j�one
Contractor Carl Kappen & Associates, Inc. Address E. 9212 Montgomery, Suite 41si-one 922-1690
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
Lot 2, Block 7, Midllome Addition •-33 —,. .1.---.511/-
DESCRIPTION OF WORK: New X Addition Remodel Moving Bld . Zone ____1_ Fire one �-
Size of Lot
127.00' x 70.11' x 107.11' x 90.00' Sewage System )ewerJ, onst. Zone
5 (Fr., Conc gk, 1 0
Stories SE Dimensions 24' X 40' X 22' X 241
Total Sq. Ft. Valuation N'9
Rooms 5 Baths 1Basement Full Foundation Const.. Concrete Chimney none Fireplace none
(Full , part, none) (Kind) (Number
Heat. System Elec. b/b4{ype of Roofing Comp. Ext. Finish Wood Int. Wall Fini hGyp• ba
Use of Bldg. Single Family Dwelling - Unfinished Basement No. of Units Bedrooms 2
PLOT PLAN
Draw sketch with dimensi s showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) dist nce to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH RESIDENTIAL — COMMERCIAL State License No.
Ina. Ins. Acct. No.
See Attached
REQUIRED
Plumbing Permit
m
m
a Heating Permit
La H Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certif information subm' ted is correct -,pthe e ar no other structures located on this property except
as shown. t---- "/ — / �' (/�� c,
Owner`r Agent Date
A LAND USE OR STR''CTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
y .IS IS NOT A PERMIT.
,ti/rt4;1 7 DO NOT WRITE BELOW THIS LINE
Your street address will be vs, ✓v (
/ 7 -L �.t-Lt> ax The zone is X�A rL@.
Sewage Permit Number Issued Building Permit i U Receipt O:2.4 Issued
Remarks f ®U 73
Form 523 Bldg. Code
Carl Kappen & Associates, Inc. c
E. 9212 Montgomery, Suite 402 Requested Price 9 9S�'
Spokane, Washington 99206 922-1690 Lot Cost 7iN
PLOT PLAN
ELEVATIONS:
Crown of Street 1�.5-1Y
Finish Floor 4-2 '/4
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