1978, 03-02 Permit App: M5164 ResidenceM
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT j
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 must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. 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
Name of Owner— G✓iyer Cr0/�ti�yatkt; ice• Address &x A4L63 %32K<s. Phone '7Z Z,09Q
Architect Address Phone
Engineer Address Phone
Contractor w %vCzo"5i" 1Zut71C,4 Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number
l.�7 3Tr�r� � 1 Srs.,�rr► Z t>-�.t. ;.G A13Dr; � `v..i
DESCRIPTION OF WOR(( New Addition Remodel Moving Bldg. Zone - 2 Fire Zone _
Size of Lot f:17 A -1 i s Sewage System I L onst. FIZZ
1'� �Fr . Conc., Br., etc.)
Stories Dimensions �� IC's Total Sq. Ft. �_ Valuation
Rooms _& Baths -Z Basement Foundation Const. Cd/y��1
Fu I, part, none Chimney (Kind) Fireplace
(Num er
Heat. System 1)1-1-14 -Type of Roofing Gump Ext. Finish 1-1/j Int. Wall Finish
Use of Bldg. ��=;i^ �r.�[� n_=Gh Lj��}f. No of Units
//lBedrooms
PLOT PLAN/dings;
Draw sketch with dimensions showing: (1) property lines; (2) street or road 1; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions ofb (6) location of sewage sys-
tem and water supply lines.
I hereby cert
as shown. -11
NORTH
SOUTH
State License No.
r oo4--Cc- Z_5 -,5-w-4
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit � '3lk�l 0.__1
in Heating Permit Pig-ky-ty4 011 F_
D
N Sewage Permit LA)Q -IT 0 "
1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
2/G/�
submitted /is correct and there are no other structyres locatgd on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT. ,
Your street address will be
Sewage Permit Number
Remarks _
Form 523 Bldg. Code
DO NOT WRITE BELOW THIS LINE
64.
C /��t 0.Them
Issued Building Permit Receipt
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