1973, 05-03 Permit App: K1535 MHAll
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PER61Ali
i
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. Wherework 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 O ���' ddress D L� Phone a0
Architect Phone Engineer Phone
Contractor Address Phone
Legal Description of Property (Give complete de cripti n from tax receipt, tc.)
acv T' �c5
--4
DESCRIPTION OF WORK: New. f�Addition Remodel. Moving Bldg. Zone � Fire Zone
SiA of Lot �iT ��� d Sewage System « Stories
Const. Dimensions -//I Total Sq. Ft. Valuation 6100
(Frame, cfo� rete, brick, etc.)
Rooms 'S4 Baths / Basement Foundation Const. /eG/ Chimney Fireplace
—! (Full, part, none) (Kind) (Number)
Heat. System G * .�ype of Roo 'ng �/ Ext. F' ish �% Int. Wall Finish
Use of Bldg. % Cs IVS / Z" m No. of Units Bedrooms ate'
Garage or irport Attached Private Detatched
PLOT PLAN
r etch with dimensions showing: (1) property lines; (2) street or road locations;.
propose buildings; (4) distance to property lines and streets; (5) dimensions of buildings;
tem and water supply lines.
m
N
NORTH
SOUTH
(3) location of existing and
(6) location of sewage sys-
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
NSewage Permit
Plans Receive
Plans Checke
Plans Returns
Plans Picked
Plans Mailed
I hereby ce- i nformation subm d is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
DO NOT WRITE BELOWITHIS LINE
The zone is
�/2
Issued Building Permit — Receipt ?_ 7 7 Issued