1976, 04-12 Permit App: L3331 Residence• 1110
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201 � .�-
-- APPLICATION FOR LAND USE OR STRUCTURE PERMIT ,7
GENERAL REQUIREMENTS PERMIT FEE
PERlr_''f 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
Spokone County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATF',I! 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.
s
nd
ents
which lareVenforce enforceable throughrs civiluld check action. Countysions Officialsf ocanants or not bringdactionntosenforcemcovenantslng with the land
or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
Architect r Phone
Contractor
Lega les ription
ddress v 7 l + - '30 a
Phone 1.2 -2 ‘ 2 iir
engineer Phone
Address 4- l* 7t2--.31 ,s, -i -16120-- Phony* N. tk— E eir
complete description,fromJ1e , tax receipt etc.)
DESCRIPTION OF WORK: New
Size of L
Const. i . Dimensions 4,C X 21
Addition
Remodel
(Frame,' concrete, brick, etc.)
Rooms—lz_. Baths 3 Basement L Foundation Const.
(F911, part, none)
of Roofing -'t.ALe
-
Use of Bldg.
Moving Bldg. o e Fire Zone
Sewage System e r Stories
Total Sq. Ft. 30 / f' L Valuation S t, A AO •
Chimney ,' Fireplace
(Kind) rt (Number),
Ext. Finish a ? / I Int. Wall Finish
Bedrooms/
�) ,2.• a .1 No. of Units
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.
�/
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a
N192.
I hereby cer/" ` iniaopmation sulitted
as shown.
1.1 azo'„,
Owner or Agent
m
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-1
State License No.
/4
65n7; „A o t . No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other structures
located on this property
/
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT
r) , - ,�: , j DO NOT RITE BELOW THIS LINE
Your street acigress will be $ / t (%”.-0 (0e
Sewage Permit, Number Issued Buildi': Permit
/,‘,176'
except
Date
CONSTRUCTION COMMENCES.
Remarks
e zone
33(Receip
Form 523 Bldg. Code