1977, 07-14 Permit App: M2449 MHs
11,
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT��// se
GENERAL REQUIREMENTS PERMIT FEE.ircP•
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 mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Nater 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
/7s//5 U S
Name of Owner
Architect
Engineer
Contract
Legal Des
Ot&., Address
Address
Address ct-r-
Address ffbt
Option of Property (Give complete des from deed, tax receipt, etc.)
ti l/a1rP�y # 2-
-3-5-
-3-h2--/6o2
Phone
Phone
Phone
�ryy� 5)_2(.1—W /4ir•al/1AG�lG.4')F Phone 4/6
Pdreel Num er
499o/e.
/
-6.3?Z
DESCRIPTION OF WORK: New _afrr Addition Remodel
Size of Lot /it, )( q0 X 9G• 9/ X 92,30
Stories.L_Dimensions '�sX 6n
Moving Bldg '^Zyo"ne / Fire Zone
�
Sewage System / tot (Fr., onsConc., Br., etc.lap
Total Sq Ft14f SAO 1lValuation,-,/poo
Rooms a_ Baths Basement — 0— Foundation Const 04-10-C-44 Chimney Fireplace —
Heat. System
Use of Bldg.
ull, part, none, (Kind) (Number
Typefol Roofing Ext Finish )i -i tt Int Wall Finish KinAer 0 -O. •
mob{,riflP [il '�f� No of Units .—Bedrooms
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.
H
NORTH
I her
as shown.
SOUTH iii 4115
rtify information �sub"mi�tted is orrect and there are no other structures located on this property except
Owner or Agent Date
A LAND IKE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
rw Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number
Remarks
Issued Building Permi
The zone pisv '-:'o 171;4 J
!/' Receipt C-76 /5 -Issued ��,Q6r�
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-
-t-�'
i
Form 523 Bldg. Code