1975, 11-26 Permit App: L2187 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 g;---
APPLICATION
jAPPLICATION FOR LAND USE OR STRUCTURE PERMIT*
1
GENERAL REQUIREMENTS PERMIT FEE
2
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
kid or alter any building or structure already erected, or to change a land use. Construction must conform with the
Slfikane 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
tit surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
S AGE 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.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner Lem .147 Address Yv207 .6 Trent / Phone / �o T/�Uo
'Architect / Address Phone
Engineer Address Phone
Contractor Address Phone
Legal Description of Pr perty I ive complete d scription from eed, tajeceipt etc )
in 7- 9 /f/o c, 6 .V0047 oae AL -3-7.r./
o ///ea -rn
/c6 67e97
DESCRIPTION OF WORK: New A Addition
Size of Lot7e4 ' X its—
Stories
/,SStories .__ Dimensions /1,C2/..(-0
Rooms Baths /Basement
/ (Full, part, none
Heat. System /-G, Type 9f/Roofing
Use of Bldg. Aid f/
Remodel
Moving Bld Zone Fire Zone 3
Sewage System 're -'Const.
a, Conc., Br.. etc.)
Total Sq Ft _s 'ei Valuation oQo
Foundation Const 25/0C -It
/21 /s1-/ Ext. Fi ish
CJ/ CYGlfa
4/Chimney Fireplace
(Kind) (Number
Int Wall Finish
No of Units _ Bedrooms 2—'
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. y�
tri
NORTH
SOUTH
I hereby certify 1 o tion submitted
as shown.
State Licen
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
rw Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other structures located on this property except
Owner • or Agent Date
(A LAND USE OR STRUCTURE PERMIT MUST BE 014 THE PREMISES BEFORE CONSTRUCTION COMMENCES,
THIS 1S NOT A PERMIT.
(9nv 11i, ® DO NOT WRITE BELOW THIS LINE
Your street address will be i�� 7 /// �� � , / The zone is ./�• Aid/ .
Sewage Permit Number Issued Building Permit/Z/07 Receipt/'/9 Issued
Remarks
Form 523 Bldg. Code
2
_tor -3/6ce _L/ovi.c aoo 4i;‘. ✓ me --0a-/-
_34b4
iaT
1 71-ey