1976, 10-28 Permit App: L6015 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT 7/ 4,
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 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 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.
P ICANT FILL IN BELOW THIS LINE
Name of Owner �� �� - ddress *-/' i'1 j ' — Phone "--"c 7
Architect Phone Jngineer Phone
Contractor Address Phone
Legal Description of Property (Give complete descriptiop from deed t receipt, etc.)
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DESCRIPTION OF WORK: New
Size of L. _2/51
Const. imensions
(Fra , concrete, brick, etc.)it x [ice - t\
Rooms Baths Basement Foun. ation Const e/)-/ ---c- -( (_
/(((%Fu11, par- one)
Heat. Systeme (t �-c �- Type of Roofing ges--- Ext Finish
Use of Bldg. (7-7‘ '—e -t -e/
Garage or Carport Attached C
Addition Remodel Moving Bldg. Zone_____J______ Fire Zone
Sewage System .--c' -c-- Stories .,------
-Total Sq. Ft / /) Valuation 5) S` `' C)
st-
��,,, ,• PLOT PLAN
Draw sketch w•th dimensions showing: (1) property lines; (2) street or roalocat ons; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensionsf buil ings; (6) location of sewage sys-
tem and water supply lines.
Chimney
�Cy
(Kind
Int. Wall F
No. of Uni
Private Detatc•hed
Fireplace
(Numbe
(,.
-0
A
/`..1"-c:
l—✓ ��
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ti 'n
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I hereby certify informa
as shown.
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State License No.
) /'—o -6ii—
�lvnd. Ins. Acct. No.
Age 0-3z) IK
REQUIRED
SIV
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
itted is correct and there are no other structures located on this property except
Owner or •gent
A LAND USE OR STRUCTURE PERMIT
THIS IS NOT A PERMIT.
-)A4%.$__/)
Date
ST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
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Your street address will be /6-,9;) �`'_ ei-f,e, ,A---- .,.e zone is k�� tL/t2 �l:!ti:.l,� k < `--
Sewage Permit Number Issued 'Building Permi • 0/ Receipt�3 7c Issued
Remarks
Form 523 Bldg. Code