1977, 04-12 Permit App: N0650 Residence Cownfy of Spokane, Washigton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT --A1
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 most 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.
•COOR'IT'ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work mus�'1JC—
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 / p
Name of Owner $,'-/-s ,S &4* K v�t? '(1','°, -t4't Address :5t' '�'oic,i 6,4 61c/-, S 10'7/V/'u"oIf'/Phone e 3p
Architect Address `.;, "a 2 'hone
Engineer Address Phone
Contractor SSM L Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) /24/Y T I . e
� .<<,1.. '7.,31>/
Lc-,- / AIK 3 C./4RI y D4 toil/ /�oDi ri i
DESCRIPTION OF WORK: New X Addition . Remodel Moving Bld . Zone Fire Zone,
Size of Lot £.?03 ' ICJ/ 1C /05,1.x.' Sewage System t;C. Const.
d !' (Fr., Conc., Br., etc.)
Stories 5'E Dimensions .?_-.?_-.51)(' 3O' 44/`A 3.2 i10
: 'X�2 L' / /fit/,l ONcrFotal Sq. Ft. /7 21> Valuation y4,Jr'CO•Ly)
Rooms 4 Baths Basement A)// Foundation Const.. O-ONer-'/ Chimney H4'' Fireplace 2—
Full, part, none) (Kind) (Number
Heat. System C LLQ 44 Type of Roofing _ LCA1p Ext. Finish 7- 1 -!/ Int. Wall Finish Dry iv4 /
Use of Bldg.AVV•it tc' K F y+de ti /# -a�Q�2/4G i= i rvcl ea Oct. /l -4svi g A ed No. of Units_Bedrooms 3
Ree re
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 �ESIDENT A- COMMERCIAL
State License No.
Ino. Ins. Acct. No.
tt4-c me
REQUIRED
Plumbing Permit
m
rw Heating Permit
cm Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUT
I hereby cer • f•.t: .:tion ub tted 's corr t and there are no other structures located on this property except
as shown.
ier or 't Date
A LAD • OR RU • E PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PER .
yL DO NOT WRITE BELOW THIS LINE
Your street address will be /3 �.�, e 2<.Ly The zone s)Clef L2 '144_ 2-
Sewage Permit Number Issued Building PermitiJ� L l) Receipt C.SL 7 (Issued
Remarks
Form 523 Bldg. Code
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