1974, 10-24 Permit App: K6155 MHr
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT o
GENERAL REQUIREMENTS PERMIT FEE /401
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. `•y
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...r r
SEWAGE SYSTEM. Pe> i s" .e 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 cov nants or dedications.
APPLICANT FILL IN BELOW THIS LINE /GSy ,¢n 9 9010 7
i � y � J • ..� iT e ct
Name of Owner CI a Address �T� Phone 111'I
Architect v Address — Phone - -
Engineer -- 6. ---Address Phone e -
Contractor ,A.(4011 / Address Phone
Legal Description of Property (Give complete desc iption from deed, t receipt, etc.) S S'I
Loa-- I t E, lace_ if, AR-icca. Mob le. N.ty
DESCRIPTION OF WORK:New Addition Remodel Moving Bldg. Zo a - Fi -Zone
Size of Lot''' / l"a lC I/O $ ) 114 Sewage System Cons Co,.. Br., et 1
Ua 1 .
Total Sq Ft D 41d Valuation 6�0
Rooms 4_ Baths Basement N 0 Foundation Const Cont_-- Blots) Chimney NO Fireplace( I'
(Full, part, none) n n (Kind) Number
Heat. Bldg. „y�ya Type - of R fpo in . EM. Finish MR -C Int of llU i Finish W6O9
Use of Bldg. Gni' ll\�'T"'o Cn V)J.L�"'t No of Units _Bedrooms
Stories / Dimensions 14 4
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.
NORTH
I hereby certify i:for
as shown.
SOUTH
on submitted is corr
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
to Heating Permit
-1
Sewage Permit
ti
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
and there are no other structure locate on this property except
/u
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
pp c /�
Your street address will be rt O .I 101-3 R q/IJCI_ lVJI-•--The zone i r "t
Sewage Permit Number Issued Building Permit j(' ,53Receipt 6 2,3 Issued t.
Form 523 Bldg. Code
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