1977, 02-14 Permit App: L6932 MH___County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
° GENERAL REQUIREMENTS PERMIT FEE 27O o
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 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 and State Health Departments. Where vork 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
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Name of Owner • • `4^j - Address Phone
/ Phone
Architect !J Address
Engineer L Address p Phone
Contractor t-+r-t"� Addresa 772
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Le Descr tion' f P (Five c mplete tonfrom deed, tax r
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eipt etc )
7,
DESCRIPTION OFF WORK: New `/ Addition Remodel Moving Bid Zone / Fire Zone
Size of Lot / 5 A / Sewage System , Const.Fr.,Conla � -I
�/ {1 i Br., netc.)
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Stories J Dimensions jilt /X 6o r To al gA Ft u D Valuation �0. 00 0
Rooms Baths "Basement Foundation Const ^- himneyN O
,Q Fireplace
�- ,part, none (Kind) rot—b-0
(Num r
Heat. System Type of Roofing tr.Ext. F.nish �`"-"" Int Wall Finish
Use of Bldg. �'t2"""L L-4 .- �+ �_. No of Units 2Bedrooms .2-''
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.
✓ e
N
as
NORTH
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
N Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
rmatioysubmitted is correct and there are no other structures locate, on this preyert%axcept
-
ner or Agent Date
A LAND USE 0 STRUCTURE PERMIT UST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS HOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be E' 7 573"/e)
Sewage Permit Number Issued
Remarks 04ni
Building Permit
2-
TY'
.� �/
The sone is d`4L
Receipt ,5-1/s/ Issued
523
523 Bldg. Code
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