1977, 06-28 Permit App: M2518 MH• 0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
ee
GENERAL REQUIREMENTS PERMIT FEE._30,
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of aqy
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 SYStUl. 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 1s 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
Name of Owner - - . - Address
Architect f Address
Engineer Address
Contractor Address
Legal Des nation of �JProperty (Give colateQdCtescri tion fro/m de5ed, �tio
S2 rneceip,tAtcAarol Numbef�e Velo8 Z J
—C5So/
2 7„d.e..Pv.�
Phone
Phone
Phone
Phone
9.216-24)//
9:g6-/./ t{ b
DESCRIPTION OF WORK: New X Addition
Size of Lot in X % 25—
Stories Dimensions
Remodel
/' ec.G
Moving Bldg. Zone Fire Zone
Sewage System i Dost. ��
IFr., Conc.. Er., etc.)
Total Sq Ft 9241 Valuation'�tt/
/ - / Chimneyles d) FireplaceNumber
int 4
Int Wall Finish VO -r, An -G•
No of Units LBedrooms
Rooms Baths Basement is —
n Full, part, none)
eat. System Type of Roofing
Use of Bldg. C ` .P. SD -m
Foundation Const
/.1ti0'C-rLr
u_- _e .�
P.•a4I
Ext Finish
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
50�
SOU TN
I hereb certify information submitted is orrect and
„1,1 C 91744 e
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25.
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as shown
Owner or Agent
State License No.
O/
Ind. Ins. Acct. No.
Cy 4-/ i -78
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
there are no other structures located on this property except
G
Date
-0.2.g-7)
A LAND '"I SE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW THIS LINE
�/ fT The zone is�011o, le
Building Permit /' )J(( Receipt 8/3 gIssned
Form 523 Bldg. Code