1972, 09-25 Permit App: J4550 MH9 0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, 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 enwater 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. \
dame of Owner
APPLICANT FILL IN BELOW THIS LINE
I
Architect
Contractorerr
Legal Desc
g UL
MIKE CHASTEN
E. 19224 Montgomery
oti, Orchard,
_f an/ 4-1.- /ygFes-1-N Address f19/12- /1/4-2IEr4 Phone_ ?t.—z.3Y3
TPhone __Eng ineer Phone
Address Phone
Wash. 9902'!
r Du9n oi novo. _ complete description f�pmm deed, •tx recgipt, e�yc.) —
o+ ` a 1 BAR.Ke� Ithitd lob. Ie tton — t2sr ten'
w
MMSS Z.— %tot—
DESCRIPTION OF3.KORK• New If Addition
Size of Lot /U) X (/2/
Const WA -me- Dimensions /1 (n o '
(Frame, concrete, brick etc.)
Rooms 5 Baths / Basement AJO Foundation Const
(Full, part, none)
Heat. SystemEllt' LTQtc Typeof Roofing
Use of Bldg. I NOAI t r Hop4es
Remodel
Garage or Carport Attached nia
Moving Bldg. Zone 1 Fire Zone -3
Sewage System S917Cd Storie s
Total Sq Ft % ta Valuation
CEMen+T
e f /*L Ext. Finish
t=ai NeNCC'
aLAcr) Chimney NU Fireplace N O
(Kind) (Number)
M �TPr I— Int wall Finish lw.) of 0
No. of Units Bedrooms Z
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
NORTH
Private Detatched
PLOT PLAN
property lines; (2) street or road locations; (3) lof ffexistingsand
an
lines and streets; (5) dimensions of buildings; () location
I hereby certify informs
as shown. -
SOUTH
ion submitterrec
r
Owner of Agent
A LAND USE OR STRUC
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
e n Heating Permit
aDn Sewage Permit
H
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
there are no other structures located on this pfoperty
Date
ERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
inept
DO NOT WRITE BELOW THIS LINE
Issued
e zone is
I/5a Receipt rl<2 Issued
Form 523 Bldg. Code
•
<OIL &takes
INCORPORATED
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Barker Road 'and Buckeye _
Greenacres, Washington 99016
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F. ilia_
WA 4-9880
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