1975, 03-24 Permit App: K7022 MHCounty 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
kind or alter any building or structure already erected, or to change a land use. Construction must
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 land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
structure of any
conform with the
j
Name of Owner .c --",--N C�i�(c"� I� Address `�'%4 L 7/" -e -.,Phone ,--.„),j'-le?,--, c
Architect Address Phone
Engineer Address Phone
Contractor Address Phone
Legal Description/of Property (Gi e,complete description from/�deed, tax repeipt, e j) �J ,c
J „ r / .,/ /C, < k- �JG r� c t'� �� P( L'//r (-C /4:44-e (' f /7 l
C[.2 E i- G (S-.5- ci- 0 ,s--/ c%
DESCRIPTION OF WORK: New Addition Remodel
Size of Lot . / X //-21
Stories Dimensions /. X < C
Rooms Baths -' Basement Foundation Const Z;;//' .
(Full, part, none)
Heat. System r'f-'/-Type of Roofing Ep Finish
Use of Bldg. //, $1, /r- /WY 71 c ry 3
Moving Bldg. Zon, ( Fire Zone
Sewage System S %%onst.
(Fr., Conc., Br., etc.)
Total Sq. Ft %,l% Valuation 4,0
Chimney Fireplace
(Number
n4;
Draw sketch with dimensions showing: (1) property lines; (2) street or road location's; (3) location of existing and
oposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
PLOT PLAN
(Kind)
Int. Wall Finish
No. of Units _Bedrooms
NORTH
m
ut
mo
SOUTH
State Licens
CI
Ind. Ins. Ac;r' No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify ,formation submitted is correct and there are no other structures located on this
as shown.
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT Al PERMIT.
--)41A4) DO NOT WRITE BELOW THIS LINE
Your street address will be (17-1!.27TL:7,e‘// i41`'2./.� /' The zone is
Sewage Permit Number Iss�ied Building it K '�Q�2,�ipt #7
pt
Remarks / 1
property except
7' -
Date
CONSTRUCTION COMMENCES.
Form 523 Bldg. Code
14)
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