1973, 03-12 Permit App: K783 MHCounty of Spokane. Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIV��yy a 0
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.
11WATER. 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 are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
Architect
Contractork)aes
Legal Descrip_ on
DESCRIPTIOq OF WORK: New
/
Size of Lot S' ..Ii a
cn Dimensions J1)'6 6— Se. .9 X/ 2 g } Sgt�Jfesq
``ap cowrete, brick etc.) �TToo�taal%l Sq. Ft. S-- g Valuayigri / O
'ms_s� Baths Basement _ Foundation Const �/e1tJ Chimney Fireplace
(Full, par. none ._,p�q_�. (Kind) (Numbe
Heat. Syste Type of Roofing .2ilieExt Finishint, Wall Finis
Use of Bldg. � , Q-4 la--' 4?td-C "• .,P No. of Units _ Bedrooms
Garage or (2 urport Attached Private Det 1uhed \'
ddress L! / 0 ViPhone '-'` - -67/y
a,gineerPhone ��,��,
Address QYZ "a- �„.„er Phone''''''''''''��/��/�(GGGG .3Q
escription from deed, tax receipt, etc.) � — ,2 �3
i 9-5— / D / 2 _ Q.-
/ 2
/9 5 -5—Z --/ A/3
Addition
Remodel Moving Bld Zone / Fire Zone ,-
Sewage .
C3Draw sketch with dimensions showing: (1)
Proposed buildings; (4) distance to property
tem and water supply lines.
PLOT PLAN
property lines; (2) street or road locations; (3)' location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys
•
NORTH
j/.2-0
SOUTH
3t ota Li ase No,
Ind, Inc. Acct, No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereb certify info tion submitted is correct and there are no other structures located on this property except
as shown.
tny(/vner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES,
THIS IS NOT A PERMIT.
” DO NOT WRITE BELOW THIS LINE
Your street address will be e zone 1
.//__
Sewage Permit Number Issued Building Permit % i Vj Receiptt�flfstate/gVelj-te Issued
Remarks lx,Th..4 Pfi) 4 -vi. %7/(I/ 10 .(7)
Br
Form 523 Bldg. Code
WEST VALLEY : EXCAVATING
3..812: DfSHMAN. ROAD
WA.4.5130
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