1975, 11-03 Permit App: L1985 MH1
County of' Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAPID
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 pork on pater 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 t e Address ��� Phone
Architect
Address Phone.
Engineer' / Address Phone
Address Phone d�
Contractor — �—
Legal Description of Property (Give complete scription from deed, tax receipt, etc.)
i 1-r �s /, ,/' , 4 n M;.z r:.).) d .fw, %P nc � /� � OG.� �/�/- /)Z,6 7
DESCRIPTION OF W RK: New Addition Remodel Moving Bldg Zone Fire Zone
FF
Size of Lot `/, Dimensions ��V Sewage System oustC.
��,�
//��..r., onc., Br., etc.)
Stories I4Z3 Total Sq. Ft. Valuation 90��
�_
Rooms 's Baths Basement �o Foundation Const./o�& Chimney Fireplace
/ (Full, part, none)/ (Kind) (Number
Heat. System 1__X-9 C/. Type of Roofing �' a� E . Finish Int. Wall Finish
Use of Bldg. /�lD//�� f1�� �S • No. of Units —Bedrooms
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.
NORTH
I hereby cert
as shown.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
N
Sewage Permit
�d
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
ion submitted is correct and there are no other structures located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
,w DO NOT WittTE BELOW THIS LINE
Your street address will be The zone is- 77`
Sewage Permit Number Issued Building Permit Receiptd2�Issued
Remarks
Form 523 Bldg. Code