1976, 10-05 Permit App: L5738 ResidenceCounty 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 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,
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
pertaining to set -back
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained
and egress.
COUNTY ROADS. Work on street right -of -way may
performed in accordance with stakes. Points of
MOVING OF BUILDINGS. A permit is required to move an existing building.
Highway, clearance must be obtained from the County Engineer and /or State
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running
which are enforceable through civil action. County Officials can not bring action to enforce covenants or
APPLICANT FILL IN BELOW THIS LINE
and
of at
ingress
not be performed until staked by County Road Department and work must be
ingress and egress must be approved by the County Engineer.
When a building is moved on a County or State
Highway Department.
separate
permit.
with the land
dedications.
Name of Owner
Architect
Engineer
Contractor
Y / II; I, (4 s- 4/...? , r.
5-17/ 7�
Address fi 1- 3 at'.- ) /.3 ‘.6 Phone '7 `7_ - ���
Address 7I t /s. ri Z Ac Zc /ii ' Phone
Address 3 �--,1 Phone
Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc)
�,• %- / /0 y
a_o `ems -�f,l
DESCRIPTION OF WORK: New /t Addition
Size of Lot C) X
;1 i1.ev1/
Stories Dimensions 1/7/ .3,(
Remodel
Rooms Baths -- Basement « 1/
(Full, part, none
Heat. System I,/ /7 Type of Roofing . <l
Foundation Const
Moving
Sewage System
Total Sq
/7C /Zr f-(
Ext. Finish t' v u cl
Use of Bldg. /Jo. s l i : `77(77A" 4 / ( Pv4 /'4
Bldg. Zone / Fire Zone 1
-'�.P/ Si ✓ ' Const % 'r is , ,i Y
ss (Fr., Conc., Br., etc.) �c
Ft %� Valuation 7 %1U
Chimney r' 4 Fireplace
(Kind) (Number
Int. Wall Finish r F, iZ ii//
No. of Units/. Bedrooms \?
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
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
nt Heating Permit
a Sewage Permit
.i
/ -x.13
7/c /f, A/r /
rifq
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certifn ormation submitted is correct and there are no other structures located on this property except
as shown.
ner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(,,,c -� i / DO NOT WRITE BELOW THIS LINE
Your street address will be e 9W., �%1,^ k L c The zone is
Sewage Permit Number Issued Buine Permit � Receiptde)/ S'31,Issued
Remarks
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