1973, 02-05 Permit App: K491 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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GENERAL REQUIREMENTS PERMIT FEE... 1,""
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.
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./--Ai'F
Architect Phone
Contractor Sid f* C
Legal Description of Property (Give complete description from deed, tax
Address 4`/iin5--eii hp Phone jdnj err rJ/
Engineer Phone
Address Phone
receipt, etc.) 9E'4 Ate ra)I 4-
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DESCRIPTION OF WORK: New 4..---- Addition
Size of Lot PO X. J.2 S—
Const. nttd 4(0 Dimensions Nn .Vi t a 4/6 Y-/% ce
t Frame, concrete, brick, etc.)
Rooms Baths 1— Basement 34 Foundation Const.
Remodel
Moving Bldg. Zone
Sewage System ,Tfrr/4
irciai Total Sq Ft /we
(Full, part, n ne)
Heat. System ,En 6Type of Roofing 0,44r, ,
Use of Bldg. - Jif f fr/e:�r e -e'
9rage or Carport Attached i/n'p2P
Ext Finish % / -
Fire Zone
Stories /5..6 94
Valuation
Chimney Fireplace —
(Kind) (Number)
Int. WalI Finish
Draw sketch with dimensions showing: (1)
posed buildings; (4) distance to property
and water supply lines.
NORTH
No of Units 1 Bedrooms
Pnvate Detatched
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
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/2 S"
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit yr
Heating Permitavid4aa eee4ir•
Sewage Permit int C /C'c 1e
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby ce in ify isubmitted is correct and there are no other structures located on this property except
as shown.
a`i+( ant � ..1r i— /9 3
net or A nt
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
Date
DO NOT WRITE BELOW THIS LINE
Your street address will be if l 5.;'_ J/' rru (h/21 B J7ki st e / rc..The zone is
Sewage Permit Number Issued��Building Permit / Receipt Issued
Remarks ,D.I'.y�,C fJ�/ ( /1-74/1-74i rrn�4 e N 7/
14
Form 523 Bldg. Code
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