1976, 10-15 Permit App: L5840 ResidenceCounty of Spokane. Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE 47(C'
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 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 la d
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications
APPLICANT FILL IN BELOW THIS LINE /; Q14 R, ,?3,5"
/Name of Owner to, Address DU ReAki21. tick - Phone 6 6.`? -9.5-6
Architect Address Phone
Engineer Address Phone -
Contractor rSA /m Q Address////` Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc) tii• C( .j3J5 92 - c>0
'
DESCRIPTION OF WORK: New x Addition
Size of Lot 4521:?r 9 5 1 X i,' o'•4
Stories / Dimensions to
Rooms Baths �_ Basement ��/��i Foundation Const
(Full, part, none
• F4 Type of Roofing
Remodel
BId Zone —/ Fire Zo
Sewage System Q� ConsConc., Br. etc.)
2 n 4/ 0 a'5 �' y /0 X / Z--- Total Sq. Ft / 7la 0 Valuation �f 00 o�
Moving
Heat. System
Use of Bldg.
,0n'1,t_ • ChimneyIndFireplace 1'
�^ ( ) (Number
/
Ext. Finish /l/ Int. Wall Finish )-« ).'4 ((
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
NORTH
RESIDENTIAL — COMMERCIAL
I her
as shown.
SOUTH
jen submitted is
1
Owner
or Agent
coand t r are
m
State License No.
C K
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
/0
Date
A LAND USE OR STRUCTUREILlttMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
6)44 341442- DO NOT WRITE BELOW THIS LINE
Your street address will be v) d'�
3 l (, c zJ.jC ,o>
wage Permit Number Issued Building Permi J`6` 0
The zone is
Receipt 14'' �(
marks
Form 523 Bldg. Code
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