1978, 02-21 Permit App: M4965 Residencej � s
County of Spokane,Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
1)
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 5�
GENERAL REQUIREMENTS PERMIT FEE ..63
PERMIT REQUIRED. A land use or structure permit is required byCoumty Resolution to erect a building or structure of an
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 SYShY. 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 mast 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. !!here 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 UP BUILDINGS. A permit is required to move an existing building. When a building is moved an 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'enforeeable through civil action. County Officials cm not bring action to enforce covenants or dedications.
�t • APPLICANT FILL IN BELOW THIS LINE
Name of Owner EXi��lYl�Slc.zln/' Addres
Architect VV Address
Engineer Address
Contractor -5150-fl ' Address 3am €
Phone Yor4s 4J%d:5'
Phone
..//)) . / Phone CO 171^P
Le el Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number/'4 V et 4042 —9061.
.t- 3s SI. a . M y ren I:ck.s -a . *mss 9067
ped -=dam /it) 5o
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone Fire Zone
Sias of Lot 70 ..,•/$2.f9 .\ 90._7 Sr h /FY•lt3 Sewage System I.t�fie. Const. Pr.
'COh f 5"'0 X 2 6 X /0 X /Y Ft 4 Ya' y.Y r., Cole.. Br., etc.)
Stories Dimensions n [ eTi 5q Ft/ eluatig, 2gFriO--
Roomscth
Baths Basement F(. Foundation Const i .NY' r.,.Le, Chlmne A� r Fireplace a
�/ a 1FYI1, part, none) (Kind) ft (Number
Heat. Systemf'at Qemp Type of Roofing Share, Ext Finish Int Wall Finish G'/�'wi�ei/
Use of Bldg./3;1,0.k Te•Sicienbe, ad Drge in be Se merit"' h'9 No of Units Bedrooms V
�/ J PLOT PLAN
3-
ezzaciLA
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 syn
tem and water supply lines.
NORTH fie so Ail
•-•-•
.
a
State License Ne.
C&R[t-T-.2V313
Ind. In.. Acct. No.
-a'y"`S
RESIDENTIAL 4
COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
mhos e
SOUTH
I hereby certify informat on submitted is correct and there are no other structures located on this property except
°s °" mid :l, aZ -thee- a (- 7 e'
Owner or Agent Date
11LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
(;•• 4' IS HOT PERMIT
DO NOT WRITE BELOW THIS LINE
Your street address will be - r f / w / (/ ` Cr7 Q The zone is �t' � •
Sewage Permit Number Issued Building Permit
Receipt (')2 y J Issued
Remarks
Form 523 BAN. Code