1976, 07-27 Permit App: L4869 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 b.45-1 "---
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 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 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 i¢.JJ2y t'_p/ f15�!/ Address 0,14/..2:2- (4LSCtt-di; '792,9 Phone '2d 9.3 '
Phone
Phone
Phone
Architect Address
Engineer _ Address
Contractor 54.IA c Address
Legal Description of Property (Give complete description from deed, tax receipt, etc.) /II /01 ,�.�cr/( ,
„›,7573--y r-. OA/ A' pielic it&7‘ rS. A
DESCRIPTION OF WORK:/New Addition Remodel Moving Bldg. Zone / Fire Zone 1
Sizff,Lot ge_ S-4.70_4/ Fe--,2.Gsf X. J:3 i.T Sewage System ezeip.if1.6 Fonst. %r���f
/) 1i �' /�'X�kS�''`'tri Fr., Conk., Br., etc.)
Dimensions 1 gX1‘ •/-„PYX .2 5 4- Copt 1.2X.2. / Total Sq Ft Valuatiorf ,5% (jai d
oonis _Baths / Basement Yy Foundation Const eQa'eA* Ar Chimney Fireplace
(Full, part, none) (Kind) (Number
Heat. System FA SLPN Type o R fing Ext. Finish .T f —/1 Int. Wall Finish .0/7 wet a -
Use of Bldg. ,'4'.y?'c_p.I? f / No. of Units Bedrooms 3
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
tOESIDENTIAL — COMMERCIAL
SOUTH
m
V1
State License No.
Ind. Ins. Acct. No.
/"J —7174e
REQUIRED
Plumbing Permit
Heating Permit ? - '2
Sewage Permit k4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby peinfor on submitted is correct and there are no other✓ ructures located on this property except
as shown.
ner o Agent
71
Ate 7�
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISESL:BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
(4_ 4!1 ' -
DO NOT WRITE BELOW THIS LINE
Tour street address will be ,2 /5 , d A/1(4 y
Sewage Permit Number Issued Building Permit
Remarks
The zone 18 )i4 -
Receipt :2-2 &-2. Issued
Form 523 Bldg. Code