1977, 11-02 Permit App M4010 Residence, Garage, Deck• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N.811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or
.*.ind or alter any building or structure already erected, or to change a land use. Construction mast
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.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a
least 25' is required, a 5' side yard, 15' side yard from a flanking street,
STATE HIGHWAYS. where the structure abuts a State Highway, clearance must be
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department
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
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.
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ng with the
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which larevenforce enforceable throughrs civiluld check action. Countysions Officialsf ocanants or not bringdactionntoaenforcemcovenantslor dedications.
APPLICANT FILL IN BELOW THIS LINE G� G
Address P 4 / riY /y3'ii/ 9 -/J Phone e - 7�
Address Phone
Address Phone
Address Phone
Name of Owner !� Y / ci V) cJ(i (1
Architect
Engineer
Contractor
Legal Description of Property (Give complete description from deed, tax
45-133 and 47.235.
set -back from the front property line,
and a 25' rear yard are required.
obtained pertaining to set -back and
receipt, etc.) Parcel
Number
structure of any
conform with,the
and work
of at
ingress
must
be
or State
DESCRIPTION OF WORK: New L Addition
Size of Lott /US �%U�/` 7c5-
Stories / Dimensions
Rooms 2 Baths-3 Basement �o //
(Full, part, none)
Heat. System L<_ 1 Type of Roofing
Use of Bldg. i nd a
Remodel Moving Bldg. Zone / Fire Zone '3
Sewage System ,`D Const. FT r2 -err
(Fr., Conc., Br., etc.)
/� a Total Sq. Ft .1'1/i3G' Valuation,
Foundation Const C r 7 ('-f' 7-7-1'' Chimney'', --e Fireplace
(Kind) (Num
/ /7 Int. Wall Finish
No. of Units _-Bedrooms
Ext. Finish
2�c
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 acd streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH
4,'
SOUTH
I hereby cer if information submitteds corr
as shown.
1r
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUS E ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
m
N
1
tate License
In'd. Ins.
ct/. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
e no other structures located on this property except
Tour street address will be
Sewage Permit Number
Remarks
DO NOT WRITE BELOW THIS LINE
Issued Building Permit
1/
Date
CONSTRUCTION COMMENCES.
'77
The zone 1
Receipt
Issued
Form 523 Bldq. Code
Nt&KtE
Kew pAith
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