1975, 06-19 Permit App: L0569 Residence.BUILDING CODES DEPARTMENT, N. 811. JEFFERSON, . SPOKANE, WASHINGTON 99201
APPLICATION FOR LAN® 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..
NATER. Plater 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 LIFE
Name of Owner< �yi?9 � Address l
Architect Address
Engineer Address
Contractor '�`-� f Address
Legal Description of Property (give complete description from deeds, tax recei
l!
t, etc.) 0 6 LE/k ,3 -
Phone % } �!
Phone.
Phone
Phone f
,;L O
DESCRIPTION OF WORK: New _I-- Addition Remodel Moving Bldg. Zone Fire Zone
Size of Lot 7 I X l 0 6 r Sewage System. s T Por nsConc.,et�c
Stories// Dimensions Total Sq. Ft. / 0 i?G VaIuation
Rooms __X__ Baths_ Basement jj Foundation Const.. Chimne Fireplace
(Fula part, none) (Kind) (Number
Heat. System e' ~LL Type of Roofing C a Ext. Fin La aS _ Int. Wall Finish�W
Use of Bldg. n::E,� d gla est x r .L%tZc No. of Units —Bedrooms
PLOT PLAN �
Draw sketch with dimensions showing: (1) property lines; (2) street or road locat ons; (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.
NORTH
Stg Li' se No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
M Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby tify information submitted is correct and there are no other structures located on this property except
as %qf;
y Owner or Agent ate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFOR CONSTRUCTION COMMENCES.
THIS IS MOT A PERMIT.
044 -Ma&0 ®O NOT WRITE BELOW THIS LINE
Your street address will be CO Zf a, z Z11-9 The /y /) The zone is
sewage Permit Number Issued Building Permit n `-, Receipt �&64Issued
Remarks V W
Form 523 Bldg. Code
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