1978, 09-20 Permit App: N0672 DuplexCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAN® USE OR STRUCTURE PERMIT
137°X
GENERAL REQUIREMENTSPERMIT FEE1-__`F/- _..
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of spy
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 nater 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.
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APPLICANT FILL IN BELOW THIS LINE
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Name of Owner (4)&2 -t iJJJ LL2i 0.1 Address & %/7 /Ul�r'.d 1G7 Phone --1
Architect a Address Phone `_aa
Engineer - Address Phone
Contractor Address Phone
Legal Dem; iption of Property (Give com ete description from deed, tax receipt. elo. ) Parcel Number
/i f' S 10c.te- / oSy/JiA- (2oa 27` �(lCLi
7i,`cm)
DESCRIPTION 0E.WORK: New Addition Remodel Moving Bld Zon
Size of Lot <' X �' 9 (O Sewage System ' rte`
Stories ��_Dimensions cQ ' X 70 C' Total Sq Ft
Rooms / Baths rX Basement/%1/14 ' Foundation Const (!t)i,4
/ fffFFFuII, part, nor`el
Heat. System
Use of Bldg.
e ,� Fire Zoge
e/C,C./ ...L(l
p Chimney Fireplace ^�
oust.
r., Co Br.. etc.)
73 Valuation 5S, l
(Kind) (Number
TYpe of W�+/Aodg .{1.iI Ae- �4�Ext�in-77—�� Int Wall Finish No of UntsciaBedroo * Il./
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.
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NORTH
I hereby certify formation
as.shown.
IOW beta
SOUTH
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State License No.
rilt2X3
Ind. Ins. Acct. No.
COMMERCIAL
UIRED'A
Plumbing Permit /�/LC./d
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ubmittedf}s correct and there are no other structures located on this property except
6/061)
Owner or Age
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PE 1T.
O 11/41 MPtej r DO NOT WRITE BELOW THIS LINE
Tour street address will be 71, .2-2/A —/cS Z3,2.4da,SIC er The zone is 2 .T.Qrozli Jett'
Sewage Permit Number Issued Building Permi OtfV &'1 Receipt g4.t 3 Issued
Remarks
Form 523 Bldg. Code
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