1975, 05-18 Permit App: L0179 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, 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 IOF 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.
REST%(ICTIVE 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 cy
Name of Owner .CS -.F AddressJg0t "- Phonel"AS'oi)2 d
Architect Address Phone
Engineer Address Phone
Contractor Address Phone
Legal Description of Property !IGive completeescription from peed, tax recei t t 1
J. I L o. w. l � SK u&l l� W � C -T G-trez... z 0 #' 2k .tom - j y t 6
DESCRIPTION OF
WORK: New '"ddition
Size of Lqt / O X /,4"-o'
1 7
Remodel
St ' l� D' o-/ X.t� �i�/V
(Full, part,none
Heat. System A T pe of RoofingCP'^- �$ "t�Fzt Finish
Use of Bldg. CS % -Nt‘tq.
Moving Bldg. Zofte / Fire Zone 0
Sewage System -re etl G onst. ,, n r a^` -
Const Conc., Br., etc.)
Total Sq Ft kik n�' Valuation a fr,�
IC\ChimneyOrity Fireplace
\� (Kind) (Number�t
Wpo 5\ \*.v Int Wall Finish G4iVSk `^.. loll.
No of Units 1 Bedrooms4:)---
Stories
''
Orles J., Imenslons
Rooms �_ Baths ) Basement Foundation Const C Ov CV
1 .
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
I hereby
as shown.
SOUTH
itted is correct and there are no other structures
Agent
A LAND USE OR STRUCTUR
7 . OTA PERMIT.
State License No.
Ino. Ins. Acct. No.
u REQUIRED
Plumbing Permit av" t 'S "ti
nt Heating Permit
D
Sewage Permit
—4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ocated on this property except
Dat
RMIT'MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
Tour street address will
Sewage Permit Number
Remarks
hemi o O 7
t2
Issued
The zone 1s G:
Building Permit /14(7? Receipt 972- 7
Form 523 Bldg. Code