1977, 03-28 Permit App: M0159 Residence la to- e,_
Caidnfy of Spokane. Washuigton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT ;, 00 0
GENERAL REQUIREMENTS PERMIT FEE '/O
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building 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.
i^ APPLICANT FILL IN BELOW THIS LINE
Name of Owner -VCAA C\ AC i'lr\P v1:77:rA rte, Address , ,C'\ 1 .''',4_ f- nr{ Phone CA Q lc--
Architect
cArchitect Address Phone
Engineer Address _ Phone
Contractor s -t- 0-1 G 0 l r^:( Address '--4 t OI ( . --a—r1 c'.( . Phone CA-'4.S.
Legal Description of Property the compete description from deed, tax rece etc.) - 7 _. - $ . . 9 -
j404— 4 f� /le ' SIke i,s E)O�7 /-7r t'V.`,/, P.-N. JEJ 4?
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone ' Fire Z e -�
Size of Lot i6.., .ic f 3 3 Sewage System y onst.- --'( �-;,,4
ly (Fr., Co -Br., etc.)
Stories Dimensions I, Total Sq. Ft. Valuati .4/ ,-Ce
Rooms Baths Basement1L1 ) Foundation Const.. -�' wc L` 1� ChimneyE,l'4 Fireplace ''(Full, part, none) (Kind) (Number
Heat. System Type of Roofing 5e- - Ext. Finish_- Int. Wall Finish LL c
Use of Bldg., �_.
, ei-� „,c,/...,A)
x� r� } Q t C1�� C - �' siiiiNo. of
Units_Bedrooms ':
(a/ 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 RESIDENTIAL—COMMERCIAL N.et eL••- -e-No.-
i
.4.- -it-it In' ns. A -t. No.
.0 it 411/ / 4:4' ,
�� y„ 7_ l:
REQUIRED
Nc;- 44
Plumbing Permit
a Heating Permit
to wSewage Permit
Plans Received
(.1 Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH �,
h re certify formation submitted is correct and there are no other structures located on t is property except
as show , f--/ '7
Owner orrAgent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
/9-7Z-ie • DO NOT WRITE BELOW THIS LINE -)
Your street address will b '/7/2/t ! -- The_,zone is.4'” "
Sewage Permit Number ' Issued Building Permit 7 a(.S 7 Receipt ,`5`DV�. Issued
Remarks Y fzli )
•
Form 523 Bldg. Code
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