1971, 09-16 Permit App: J0779 MHCounty 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 must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. 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 Ior dedications.
APPLICANT FILL IN BELOW THIS LINfE��, nn ` Id^�' cf -G
Name of Owner L1 QQL POU O' Address I_ , jc.WC OrW r) , Phone W M -` &t 0
Architec; MIKE CHASTEK I_ Phone Engineer Phone qts _2Z S"
Contract) E. 19224 Montgomery 1Address Phone
Otis Orchard, Wash. 99027
Legal Deb ripnon-ui rrupe cy-use complete description from deed, yix receipt, etc.)
-,t 116 elm 0/44ti fn_Ytl K ➢
(_D4s ST1 — O3 i L
D CRIPTION OF WORK: New s's'Ar` `Addition Remodel Moving Bld Zo Fire Zone s
zeLot 70y /3 Ky' 72 1,-0 Sewage System d°j2 storie
Const,. - l i' AVv"t.- Dimensions y X St Total Sq Ft /3W Valuation / y 006
(Frame, concrete, brick, etc.)'
,e n,, - ' �I 1
Rooms G Baths 1 Basement Nr7 Foundation Const �'o_ o,,, 1 Chimney to a Fireplace Mt
(Kind)(Number
h
-nn (Full, part, none)
Y
ng
Heat. System] Type f Roofing N- Ext Finish Int. Wall Finish
MA'S (14 � �-� 1
Use of Bldg. No of Units Bedrooms 2—
Garage or Carport Attached
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.
Private Detatehed
NORTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
▪ Heating Permit
u, Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted/'is corre t and there are no other structured located on this property except
as shown. (i/(�
? 6 (-) (--
Owner or Agent D to
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT..
G pDO NOT WRITE
�BELOW
�� THIS LINE �(n,, _ /
Your street address will be r 1 p O(7C Al (141-4>k /t/�"-Y e zone is
1 �L'71�+v_L
Sewage Permit Number Issued Building Permit O1 / , Receipt Issued
Remarks
Form 523 Bido. Code
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Barker Road and Buckeye
Greenacres, Washington 99016
WA 4-9880
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