1974, 07-10 Permit App: K5195 Residence• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND 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 most 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 onwater connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
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 thestructure 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/9r 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.
r�) APPLICANT FILL IN BELOW THIS LINE 9,-.2 7
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
Name of Owner .0 • / f .1 Address
Architect Address
Engineer Address
Contractor " fl- . ft .Yn l aN Address
LegAL,Description of Property (G'vi a completeCdesc iption from dee1rta+� receipt etc ) en 9.S 9
4
Phone
Phone
Phone
Pe
//UI /
Lot -.G, /1— tam -c, etc
DESCRIPTION OF WORK: per Addition
a
Size of Lot
Stories
Rooms
Remodel
Dimensjo
61 -<f2 -4z — C2>xZ
I
Baths Z- Basement Foundation Const
-- ' fart, nonR ,,,
Type of Roofing (��''`°�Y���� ice(
�t v�
Heat. System
Use of Bldg.
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and -water supply lines.
YC
Moving Bld zo Fire, _Z� e 3
Y- ' ,
Sewage System ' ( Const.
Fr„ Con ., Br., arcs o,
Total Sq Ft f,1-° Valuation i 00
Chimney Fireplace
�qJ (Kind) (Numb_.
Ext Finish (/f.Q Int Wall Finish r -s) a—Q. n
of Units _ Bedrooms -3
,PLOT PLAN
property lines; (2) street or road
lines and streets; (5) dimensions o
cations; (3) location of existing and
f buildings; (6) location of sewage sys-
State License No.
(99
. Acct. No
REQUD
Plumbing Permit- -
m Heating Permit
Sewage Permit
SOUTH
l
I hereby certify infor�aya��/sr/,rye-tted is coriect.aand there are"n`o other structures located on this property except
a� shown. .%7 .Gf 'Tc� \ \� 7 10/7 1
/1[\ G/ 1 1 Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
Owner or Agent
DO NOWRIT BELOW THIS LINE
Your street address will be / ei a JOI e
.,/
Building Permit/ Receiptispr c Issued
/The zone is —
Sewage Permit Number Issued
Remarks
Form 523 Bldg. Code