1974, 06-17 Permit App: K4953 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, 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
kind or alter any building or structure already erected, or to change a land use. Construction must conform with
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 ny 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 ,177,11), -%?/c-/ !tet /ere- "e- �— Address
Architect Address
Engineer Phone
Address Phone
Contractor Address
Legal Description of Property (Give complete description from deed, Phone
tah
Phone Zf— c,
j/ � / ex receipt, e l `� 1/
/j/c)c /� L 4.1) /�lC (, .0 r5i/ /41,11/ if' /r rh c
DESCRIPTION OF WORK: New / Addition
Size of Lot '79X//
Stories / Dimensions ,,2 ` 7' X -5-,6
Rooms _,:5 BathsBasement
Full, part none)
Remodel
Moving Bldg. Zon
Sewage System
Foundation Const.
K
• Heat. System ,E'/'c. Type of Ropfing Ext. Finish
Use of Bldg.'� :, , M2c <,i7
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
NORTH
Total
--— Fire Zone
Oonst.
(Fr., Conc., Br., etc.)
Valuation l-/Oo
Sq. Ft /3`/y
Chimney Fireplace
(Kind) (Number
Int. Wall Finish
7 , ar.z < <
No. of Units _ Bedrooms
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
SOUTH
I hereby certif}ji tion submitted is
as shown.
Owner or Agent
correct and there are
State Lice se No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
no other structures located on this
property except
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
Your street address will be � 5 �� //c -r
Sewage Permit Number
Remarks
Issued Building P
it
The zone is //#/
Receipt 63W Issued C /S ,_
Form 523 Bldg. Code
i
to -i go( Lba).0.0 Zs/ //41/j e
7,5(5-2c /1704
L,i4eJy
f
9
1
Tie'
U