1977, 02-18 Permit App: L7212 MH(Th
C&z ty of Spokane, Washn(gton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE 7d d
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.
1 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.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
Architect
Engineer % / Address �
ContractorPhone Addre-� i 1I
��y��
Legat'pescrip r opsrg
Pry (Give Womplet desc'pti n fro deed, tax rece1tc 1 �.�;L'I-'
Address Phone
Address Phone
D S'S'Si---/O a 3
DESCRIPTION OF ARK: Ng
Size of Lot i(
Stories / ,Dimensions
Rooms Baths
Heat. System
Use of Bldg.
w Addition
/1 S'
iv'
Remode l
16
asement 1" Foundation Cons
I, part, none', •--��
ype •f Rogfing
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
Moving
Sewage Syste
BI
Zone
Fire...Lane 3
onst.
Qy Fr.. Conc. r., etc.)
So t v!Q Valuations O0 e -d d
imney (/1/6 Fireplace
HHH (Number /
Int Wall Finish ���t-�[
No of Units Bedrooms y.
d
PLOT PLAN
property lines; (2) street or road locations;
lines and streets; (5) dimensions of buildings;
NORTH ""24t'd'U
SOUTH
I hereby certyf"y,linformatlon submitte is correct and there are no other structures located on this property except
-a A .t ---; A--1 g---77 %
Owns r Agent Date
A LAND USE OR ST TORE PERMIT MUST BE OH HE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT. •
(3) location of existing and
(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
as shown.
--i
Your street address will be £2_L50
Sewage Permit Number
Remarks
DO NOT
r
RITE BELOW THIS LINE
Issued
Building Permit
1
The zone is 4yn24 /Sri--
Receipt '"$3B Issued
Form 523 Bldg. Code
/ �> J
o � N ��-uM Me