1975, 10-31 Permit App: L1968 Repair Fire DamageCtPnfy of Spokane. Was gton
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 mast 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 47235
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
1'
Name of Owner
Architect
Engineer /�t
Contractor—rie-SM- ( erll_a
Address
Address
Address y
as-,rt,47/Address �/2-71-9-+P
,PLegal Description of Property (Give complete desbripti
,t.t6 /3 .. A,
on from deed, tax receipt etc 1
/.rte
Phone
%� !� Phone / �7
P J/,J67 Phone «j -a
Phone
44,3-5-09.2-a
DESCRIPTION OF WORK: New Addition Remodel L ------Moving Bldg. Zone / Fire Zone 3
Size of Lot / 3 S � �C 4 9/CL
0 ' Sewage System - 1F Conc.,
Dimens�ijeq/np•s� / CL2)/1-•"(_
/ Total Sq Ft Q Valuation .�3.-0 Q
Wet. System 14/63.,_ Type of Roofing Ext Finish
Rooms Baths/
18
Basement ultdation Const ��``� M / Chimney (Kind) Fireplace Number
6�FF �� I / Int Wall Finish ,e/
onst.
r., Br., etc.)
Use of Bldg.
/� • . �.• �•
• 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.
m
N
y
NORTH
`R IDENTIALCOMMERCIAL
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
w Heating Permit
IASewage Permit
-I
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
. SOUTH
I hereby certify information. submitted is correct and there are no other structures located on this property except
as sh _ // ////�// , ,
•tit .fI 1Cv 1�;��1/_L.✓�7--Cy2^,� /0-0/-7
:+' :"'-owner or Agenet _ Date
A LAND USI 01 STRUCTURE'PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
r ,THIS IS NOT AP,ERMIT.
Your street address will be
Sewage Permit Number
Remarks
DD0 LIOT WRITE BELOW THIS LINE
�` E%ri[�n.a-f" The zone is
Issued Building Permit•; /14 Receiptr)(/(y)
Issued
Form 523 Bldg. Code