1971, 03-16 Permit App: I3747 MH1
County of Spokane. Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201 0,6
APPLICATION FOR LAND USE OR STRUCTURE PERMIT /
GENERAL REQUIREMENTS PERMIT FEE I
PETIT 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 must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. 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
which are enforceable through civil action. County Officials can not
APPLICANT FILL IN
E . Y
Name of Owner L '1 t -
Architect Phone Engineer
Contractor Pe‘.0 b�CrSI
Legal Description of Property
i
r' ,L: k' 1 Address
BELOW THIS LINE
or dedications and easements running with the land
bring action to enforce covenants or dedications.
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Phone &) �1 '/{6 J/
Phone
Address Jf 9 C(tcJ1 k_KC--=J (:.rru f Phone L.r_, n-- ,-s.f \c1
Yoet-
(Given complete descriptiAn from deed, tt
ax recei ^( etc.)
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5- z, �S
DESCRIPTION OF WQRK: New_`C4ddition
Size of Lot — J ?C / 1 I
/
Const. ( icc}4)1 L Dimensions 1 Z- Y(60
Remodel
Moving /- Bldg. Zone ' Fire Zone I�
Sewage System $V'1 • C Storie _
Total Sq. Ft `l 10 Sj f' f Valuation
(Frame, concrete, brict, etc.)
Rooms_ Baths Basement \ `y Foundation Const
(Full, part, none)
Heat. System pi L- Type of .Rfoofing MG?'A L Ext. Finish
Use of Bldg. IN\n; Ie_ - ,.,1Cocarc
Garage or Carport Attached
Chimney 1\1i r Fireplace
(Kind) (Number)
M1— Int. Wall Finish Woos{
No. of Units / Bedrooms
Private Detatched
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-
tpnf and water supply lines.
m
N
NORTH
SOUTH
I hereby certify information sub ted
as shown.
. 4.i-'-
m
i� or'ect ad there are no other
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit v ��
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
DO NOT WRIT
Your street address will be / 1 0 0
Sewage Permit Number Issued
Remarks
BELOW THIS LINE
Building P
.1(--L1he zone is`-�
mit' 37q-7 Receipt _Issued
Date
CONSTRUCTION COMMENCES.
Form 523 Bldg. Code
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