1977, 03-03 Permit App: L7259 ResidenceCounty 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 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.
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 LIN
Name of Owner
Architect
Engineer
L Address Phone ` a e-.5(.0
Contractor ✓J j -%7t -C' /
Address Phone
Address Phone
Address Phone
Legal D cription of Property,, (Give complete description f om deed, tax receipt, mg.)
./z -r; " r "�-2 ._, ,t(/a.ft ;z.- / J-` 4-/_.!-f(
^<r ?eSvc — 5
DESCRIPTION OF WORK: New Addition Remodel
Size of Lot r �% rX
i f
Stories / Dimensions
i
Rooms <S Baths 4- ` Basement/ dJ Foundation Const
(Full, part, node)
Heat. System f:
' 't'YType of oofing
Use of Bldg. Q4 - a cA CA -19 ?",?,c
•
r .1
i
Moving
Sewage System
BI
Zone / Fireone
Const
onst.
(Fr., Conc., Br., etc.)
//Vall'uation
-/-,4---tire lace
(Kind) Ci Glum er
Int. Wall Finish
Total Sq. Ft
Chimney
[ - Ext. Finish 7 /i7
t!�
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
m
ui
NORTH
PLOT PLAN
property lines; (2) street or road locations;
lines and streets; (5) dimensions of buildings;
No. of Units _Bedrooms
ESIDENTI — COMMERCIAL
SOUTH
I hereby certify information submitted is correct and there
as shown.
(3) location of existing and
(6) location of sewage sys-
State License No.
6 a -eE -a6-0 /r7/
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
are no other structures
located on this property except
— % 7
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
Tour street address will be t` j i it
Sewage Permit Number Issued t Building Permit
Remarks
DO NOT WRITE BELOW THIS LINE
The zone is !moi'/ '!C. ,
`C 3 5 / Receipt -Sl 7 Issued
Form 523 Bldg. Code
• r 2, /.c 7, 14, 1 Y 01 -al 4t *AO
dia% dr gout lit 'AN"'
coo Se".
p"P
• .
t Gotlica
4 vt
A