1976, 12-06 Permit App: L6564 MHCb+unfy CO Spokc ne, Wast►. Igfon
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.
Name of Owner
Architect
Engineer Address
Contractor "� "'r -77-1-a-, • Address
Le I Description of Property (Give complete
APPLICANT FILL IN BELOW THIS LINE
%4) 6
`1.11cT (� Address 7 y ! g '�1 Phone
tl
Address Phone
Phone
n Phone
description from deed,tax receipt, etc 1 c9. S 3 q Q
%Zc.c.)
Addition Remodel Moving Bldg. Zone /
DESCRIPTION -QF WORK: New
Size of Lot p
Stories /
/JO 0 t') rpt Ccs- - oy
Fire Zo e
Co
,$r etc.)
Sewage System C onst.
Dimensions B 7* lC d '
q,( /42-.7e,/i,-.) Total Sq Ft
Rooms/ Baths f Basement r
(Full, part, none)
Heat. Sys em type of Roofin
Use of Bldg.
Foundation Const
Fr., C
Valuation
_Par Chimney Fireplace
(Number
Int. Wall Finish
No. of Units_ Bedrooms p��r
Ext. Finish 117-6-6-A—/--7
,61,0m, �i A .ilk - -- -1,c-c
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. /
t NO TI
RESIDENTIAL - COMMERCI L
m
a
I hereby
shown.
rtify informatio
Owner
or Int
SOUTH
subitted is
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
correct and there are no other structures
Date
located on this property
''--(6 /iG
except
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 b�
Sewage Permit..Number Issued Building Permit
Remarks .•,Cl�J�-C� Q - / 7 6 t7 ,
J� i ' The zone is / "
405/ib% Receipt sued
•
Form 523 Blda. Code