1973, 06-11 Permit App: K1924 MH• •
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 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 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 �3 �j�QQ Address qT7;7,-,4r'T Phone_41/_X I__Zei51'0
rCO 9
Architect Phone Engineer Phone
Contractor Address Phone
Legal Description of Prrnn ty (Give complete despription from dee tax receipt etc., -�
/�J/ y/ 1 h e) ill P /- - a --
20 7 .3 4c. k Oil L{Mel v / c'
DESCRIPTION OF WORK: New Addition
Size of Lot
Const Dimensions
/Lilt/4.40
(Frame, concrete, brick, etc.)
Rooms -6 Baths _____Basement 145 Foundation Const
(Full, part, none) /
Heat. System Ce C.-
Type pf Roofing /hhv,J / i
Use of Bldg. iUb l / C. Acm' c
/--2 -s
Remodel Moving B1d . Zone3
�� / Fire Zone
Sewage System t7 7 ,T11/ C._ Stories
Total Sq. Ft 7c2 0 Valuation 70 O cu
/J/OC/c
Ext Finish A7 ✓d/ /
kte Si Wen c.
Chimney Fireplace
(Kind)
Int. Wall Finish
f
No. of Units
(Number)
Bedrooms
Garage or Carport Attached Private Detatched
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 buildiigs; (6) location of sewage sys-
tem and water supply lines.
PLOT PLAN
NORTH
I her
as shown.
SOUTH
tify informati.; ubmitted is
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
correct
and there are no
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
HSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
other structures located on this property except
�a
eZ,4..et , 7444 -X. --k DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number
Remarks
Issued Building
Date
CONSTRUCTION COMMENCES.
,�.�,.0_
The zone is /flt9-C-C
rmit /9"..24/ Receipt 7/ 7 Issued
Form 523 Bldg. Code