1976, 05-17 Permit App: L3894 ResidenceC4►4nfy of Spokane, Wash,rdgfon
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
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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 must conform witty 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 land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner �► 14' n Address gt,X6' P " /t•e% Phonelz/Pf`%'1-7
Architect Address Phone
Engineer Address r� �� / / Phone
Contractor /�C y /1/4111 e $-, TIT G Address /5:04- r( - /4' to 1.2 h-/ Phone ���- "5-..r.7
Le aI Description of Property (Give complete description from deed, tax receipt, etc 1 Atte ignite - 255 Y/ - 03 a 7
.07 7, '/96A-.. j F.oh-reAte 47 f77i.r.
DESCRIPTION OF WORK: New ✓ Addition
Remodel
Moving Bld
Size of Lot /O a ' . //,(/ 4- / R / ' (.- /1"
D I•► y a r
OILj /' 3 /,x
Stories Dimensions
Rooms Baths 2 Basement
F�►II, ppaaarrrt, none
''Type of Rgofi
Ci �
Heat. System
Use of Bldg.
73'o.a,
Foundat
ng
c 1
eit
Sewage System
ion Const
44txt.,Finish
,Ctf
Total
. Zone
v6
Sq. Ft
Chimney
Fire Z�oe -
�onst. e-
F/r., Conc., r., ejcc.)
Valuation .4/
(4$124'
K nd4'/4 Fireplace 4-
Int. Wall Finish Pfe:4T.UN1t44.0
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
NORTH
RESIDENTS COMMERCIAL
I hereby
as shown.
SOUTH
certify in ormatio ubmitted is correct and there are no
Owner or Agent
State License No.
22.7-o/-/ r Yy 0-2n 7
Ind. Ins. Acct. No.
277Zy'P
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
other structures located on this property excNpt
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be . y� ,yaG
�frL�v � .0The zone is yJ l - / 1446:;-0.1'
i
Sewage Permit Number Issued Building Permit �7 Receipt Issued
Remarks
Form 523 Bldg. Code
1