1977, 06-20 Permit App: M2450 MH•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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GENERAL REQUIREMENTS PERMIT FEE J.R
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 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' 1s 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 0
Name of Owner
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Address
% �?x Phone 9alfr®7?a/
Architect Address �/ Phone
Engineer Address Q9D/4� "�� x�Phone
Contractor Ilia- 64.- � Address Sn rJ D 'L %d.eir tA.�te/ Phone 9x6' —11 y9
Legal Desc prion o Property (Give complete description from deed, tax receipt etc ) /
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DESCRIPTION OF WORK: New
Size of Lot
Stories)/ Dimensions
'7
Rooms Baths
u(IB p
/1 Addition RemodelMoving 4G Bldg. Zone ..�— Fire Zone .�
X/2 -5 -Sewage System 2e -clack Const.
—
/ 2 X (151 Total Sq Ft.5 f Valuation 7,,
semens '-49 Foundation Const Chimney Fireplace V�'Y
artnonce (Kind)(Fr., Conc., Br., etc.) 60
06 a
(Number
int Wall Finish JL��
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Ater>rteQiJ tiL-e-¢-fA-t-�f/{'�/ No of Units.— Bedrooms �-
Heat. System Type of Roofing t. Finish 7..<2.W
Use of Bldg.
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 sup ly lines.
COMMERCIAL
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as sh
SOUTH
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State License No.
/,u/-,er-A4/-Fa6oJJ
Ind. Ins. Acct. No.
W"/72
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
by certify informatlop submitt»d is correct and there are no other structures located on this property except
—,20
Owner 77
Owner or Agent Date
A ' D USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
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Your street address will be / 7 3'o7 / 5 ` - r .�((� The zone is
Sewage Permit Number Issued Building Permit/ II Receipt 7 3neIssued
Remarks
Form 523 Bldg. Code