1974, 10-15 Permit App: K6036 MH•
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County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT Y/ i g
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.
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.
HigIwa OcBUILDINGS.
mustAbepermit
obtainedr fromred theto move an County Engineeriand/orlState Highway. When a bDepartment, is moved on a County or State
Highway, clearance
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
%cY)U i 77,,---.7t
Name of Owner
Address
Architect Address Phone
Engineer t� / Address ,Ph
Contractor �0/ . 7f-4� ` Address P 2SC 2 cc"'..)-4-47--,—ii?Phone ' Cc c -d
Legal Description of Property (Give complete descr tion from deed, tax receipt, etc.) sC
-) ., „/(4-> i, / Poev amt., V ---,Cc', -/- Agf24 4 122c• A%*-
-ei.r,1, -';,? ./e,"." � * C5 6 .5-7r V/— aa_ 0 -
Phone 92-11-f14e9"/
DESCRIPTION OF WORK: New Addition Remodel Moving
/9/ Z -^I, s�lr
Baths / Basemenndatlon Const
himnev
Si$e of Lot
ries Dimensions
li
Iwooms
Heat. System c%c/--/ Type of Roofin _2 ' —'Ext Finishr • O Int Wall Finis
Use of Bldg. ,A14 le /7z4'c� '�'-S :d 1 r'-rlc�rr,--- No of Units
Bldg. Zone.
Sewage System a) `'r7 c..
�Tot/ial /SL,q Ft Val
"1 C' �: �-P^
Full, part, none (Kind)
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raw sketch with dimensions showing: (1) property lines; (2) street or road locations; 3) location of existing and,
oposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings;
em and water supply lines.
PLOT PLAN
Fire Zone ^-r�1
tC "wwLe O
Conc., Br., etc.)
uation 71°
0 u
Fireplace
���rrr,,, I Number
Finish
edrooms
NORTH
(6) location of sewage sys-'
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
SOUTH /
I hereby cert'fy information submitted is correct and there are no other structures located on this property except
as shown.
Owner otrAgent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCESS..�
THIS IS NOT A PERMIT. lips , //)06• i`4
/.S /17/
Date
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Tour street address will be, 33 C) /1/A,/GUoThe zone
Remarks / z ��
Sewage Permit Number Issued Building Permi_/QQ9 Receipt •.St Issued
DO NOT WRITE BELOW THIS LINE
Form 523 514. Code
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