1976, 11-10 Permit App: L6161 ResidenceCt..anty 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 mast conform ■ith 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 eg •ess.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
Derft med 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 nr 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
J,�1�
Name of Owner "" 1' t' -`u Z+* � ; , / Address �l0 3 ,"� % �`1fi 7-4 G%� - Phone Q� "
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Architect Address T 7d (2 Phone
Engineer Address Phone
Address Phone
Contractor ,,Sdit,-fJ
Legal Descripti of Property (Give complete description m deed, tax receipt, etc
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N�/� -rte
DESCRIPTION OF WORK: New l/ Addition
/ 3 O - /
Size of Lot
Remodel Moving Bldg. Zone / Fire Zone ":'
Sewage System .`-J,7 onst. �r 4- "" sL
(Fr., Conc., Br., etc.)
Stone Dimensions C' x 1 Total Sq. Ft Valuati�r�� 'k 2 ' Q
Rooms ( Baths Basement roil // Foundation Const, (' /ICJ"'/'�- Ch'mnef `-' »" Fireplace
Full, part, nonel (Kind) , (Nu
Type of Roofing Ext. Fini h . Int. Wall Finish
121J\ t ���,. No. of Units _ Bedr•oms
Heat. System Et.
Use of Bldg.
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
m
iA
NORTH
PLOT PLANo
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
RESIDENTIAL - COMMERCIAL
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
rn Heating Permit
NSewage Permit
SOUTH
I hereby certify informatieti ubmitted is correct there are no other structures located on this property except
�s shown.
7/77/14,
77 n/ (,. I- -- � / // C) `iLo-
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0�Diner f' ate
o Agent
A LAND USE OR STRUCTUERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
1L,41 NOT WRITE BELOW THIS LINE
Plans Received
Plans Checked
Plans Returned
Plapa•Picked Up
,,,--"Plans Mailed
THIS IS NOT A PERMIT.
Your street address will be - -,'-»' �Y41, 'L� The zone is
Sewage Permit Number Issued
Remarks
Receipt Z./S-7='`, Issfied
Form 523 Bldg. Code
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CHAPCO CERTIFIED CONSTRUCTION
10821 E. 26th Ave.
Spokane, Washington 99206
JOB NO, 27
Legal description: Lot 16, Block 3, Myron #5
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Bowdish High Court