1976, 08-02 Permit App: L4938 Remodel, Renewal of K7445, K3448, K3670•
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County of Spokane. Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
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/2
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 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 arle through civil action. County Officials can not bring action to enforce covenants or dedications.
a APPLICANT FILL IN BELOW THIS LINE oiW-cy(
Name of Owner L -=�- - ��� Address J - - Phone 91- - Yoz?
Architect Address Phone
Engineer /l Address Phone - -
Contractor ' -4-int R Address /G��l Phjn r
LeDescriptionDescription of Property (Give complete -q/.e,sscnptioay, from deed, tax receipt etc ) ( /�..S mete `- / .(�J S�� — 1 6
51- Ir
/f./ . /D/ i ',.r-* F 1tu�ct cam../ -
DESCRIPTION OF WORK: New ' Addition
Size of Lot /0 O ,70'
Remodel
Moving - Bldg. Zone / Fire Zone
Sewage System (Fr., nsConc.. Br., etc.)
e" " Valuation
Stories Dimensions ,eiiiiD V. tj 6 r - Total Sq Ft
Rooms -. Baths i Basement Foundation Const �-4VG Ca Chimney Fireplace
Full, part, none) (Kind) (Number
Heat. System...,e,„
Type of Roofing Ext Finish Int Wall Finish
Use of Bldg. f Q , 9.2 id 7- f �� No of Units _Bedrooms i�
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-
and water supply lines.
NORTH RESIDENTIAL - COMMERCIAL
SOUTH
I her y cerci
shown.
Dei - ▪ o▪ r Agent -
fy informatio
bmitt
State License No.
Ind. Ins. Acct. No.
vR-6-1 C4
EQUIRED
PI tubing Permit
m Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
c ct and tfiere are no other structures
Date
located on this property except
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 15 NOT A PERMIT.
DO NOT WRITE BEL W THIS LINE
Your street address will bell ii- Q 9-- "71 /
Sewage Permit Number Issued Building Permit
Remarks
%
The zone `i1s
Receipt .9 )1'2- sued
Form 523 Bldg. Code