1972, 06-12 Permit App: J3439 MH1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT rG
• ;WZNERAL 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 N. 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back frcxn 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 OP BUILDINGS. A permit Is required to move an existing building. When a building 1s 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 IH BELOW THIS LINE c
Address C. I 2-0 li- Phone qZr -
Name of Owner
Architect_ '— --- --shone Eng inset Phone
MIKE CHASTEKPhone
Contractor E. 19224 Montgomery Address
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wq;amp to de riDtio ftom deeedLnx ec_VRi, pt,
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al Descri,
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DESCRIPTION OF WORK: New 1']` Addition Remodel Moving Bldg.Zong Fire Zone
•/ r [.Zan Stolesi
iCont Lot O �� % Sewage System _ _ _ Valuation
Const I)ct Dimensions ID- --1 6 o ' Total Sq.Ft. ZO
pit Frame, concrete, brick, etc.) (�� ,1 No
r).1Rooms. Baths a+ (0O Fireplace
S _�—Basement Foundation Const Chimney
4't (Full, part, none) ( /J (Kind) (Nber)
Heat. System C Type Roofing ��' f E t Finish (N11-474,_ Int. Wall Finish coves
Use Bldg. No. of Units 1 Bedrooms
Cnrago or Carport Attached Private Detatehed
of
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. State License No.
NORTH
od5t) clot
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
MSewage Permit
H
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information bmitted s correctthere are no s and other structures located on this property except
as shown. _-�A/
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE OH THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
•lour street address will be To r I7 z0 > /Y/ i Re zone is
Sewage Permit Number Issued Building Per Receipt O Q n1 Issued
Remarks
Form 523 Bldg. Code
V'LL�R EitatEs
INCORPORATED
Barker Road and Buckeye - --
Greenacres, Washington 99016
WA 4-9880
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E. N203 a,ztt9
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