1977, 07-06 Permit App: M7102 MH• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT s°
GENERAL REQUIREMENTS PERMIT FEE
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 jnJ �uP �4
Name of Owner / .�. _/_ �/� . 1 ! . Address �n qQ 2 C J�./�♦ Phone ��� '/ Td
Architect Address Phone
Engineer Address Phone
Contractor aQ i - i'J Address Phone
Parcel Number -7'`71'3 —a ?4D - .Q F-0 (4'
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
A-0 Til/!1- // -_/-2 0.4..1C
DESCRIPTION OFrWORK New
Size of Lot
?� Addition Remodel
Stories j_Dimensions / x/X 6 f 6 X/o
Rooms ., - Baths -ZBasement A Foundation
(Full, part, none)
Heat. System T,ype of Roofing
Use of Bldg. 4
�
Moving BId . Zoe 1 Fire Zone --)
Sewage System .,140.,G'Const
(Fr., Conc., Br., etc.) Qa_
//JJ Total Sq. Ft ql/(- Valuation /404
Const ( .r�lo,- f J44Q Chimney A/A Fireplace li/'4
(Kind) (Number
Ext. Finish i 1_, Int. Wall Finish P/iVD(1-
No. of Units Bedrooms
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location
tem and water supply lines.
u
S Tt+' A, I./
NORTH
SOUTH
existing and
of sewage sys-
State License No.
Ind. Ins. Acct. No.
ESIDENTIAL COMMERCIAL
REQUIRED
Plumbing Permit
n. Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
7/7/7r egie
I hereby cert fy information submitted is correct and there are no other structures located on this property except
as shown. X
716`7 7
Owner or ent Da e
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT AplitlT.
IN\
00 NOT WRITE BELOW THIS LINE
Your street address will be '�
O0� Z , �� ,t_Q %!j �
Z The zone is, RLQ.
Sewage Permit Number Issued Building Permit Receipt Issued
Remarks
2
Form 523 Bldg. Code