1977, 02-14 Permit App: L6926 MH1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT_ -
GENERAL REQUIREMENTS PERMIT FEE a 7o Z%
PERMIT REQUIRED. A land use or structure permit is required byCounty Resolution to erect a building or structure of au
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 end State Health Departments. Where work onwater connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office. 99
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
Ind 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 !"/4-Fii o t Address Phone
Architect Address Phone
Engineer
Contractor
Legal escrippponlicn
l•
erty (Wye complete
, �;e.eff
Address ,_— e6Phone
Address
one
cS"ption from deed, tax receipt �ajy 1 Arrow �A
im
DESCRIPTION OF WORK: New Addition
Size of Lot 7 0 ' )9 �J// s
ire Baths �— Basement
s Fu J, part' none
Stories / Dimensions/t Jar
Rooms
Heat. System
Use of Bldg.
Remodel Moving Bldg.. Zone / Fire Zone i
Sewage System oust. `�fl..6-«H.-2
r Fr., Conk-, Br., etc.) 'a0.
of 1 sty Ft Q ° Valuatilt pe -�_
1 Foundation Const. 4 -Chimney ind) Fireplace
(Number
Type of Roq'IMP Ext. Finish p �� Int Wall Finish/ t>an'1
-ez!7 a Aza-[-,l -z, -C_Q-r 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 RESIDENTIAL — COMMERCIAL
I hereby
as shown.
tify in
SOUTH
ormation Submitted is correct and there are
- State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
So
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
no -other structures located on this
F9-4 1
property except
Owner or Agent
Date
A LAitiD•U&e OR STRUCTURE PERMIT MUBE ON THE PREMISES BEFORE CONSTRUCTION C MEM NCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number
Remarks
The zone is
Building Permit Receipt .52t:?/
Issued
Issued
Form 523 Bldg. Code
J