1975, 06-10 Permit App: L0421 Residencei •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE .yy_.Sl
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 , " - Address
Architect Address
Address
Address
Engineer
Contractor
7 9�D3
Phone y
Phone
Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc I Q
phone, --5-3 o23>''
/Ll�s`�.7-a7,-/
DESCRIPTION OF WORTS; pew {,S• Addition Remodel Moving
Size of Lot 5/ k 3 V -
Storie
Rooms
Dimensions c --,2l " X 3 V
'Baths / Basemen
(Full, part,
Type of Roofing
JJ C/
Heat. System
Use of Bldg.
Foundation
/y2-Z—
Const, /� Gam"%-� Chimney )/41Fireplace
Bldg. Zone / Fire Zone
Sewage System onst -� e
Fr., c., ., etc.)
Total Sq. Ft ���%Valuation
(Kind) /(N m
nt. Wall FinishQQ-I�-/J-f0�
of Units Bedrooms ��
Ext. Finish
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.
m
NORTH
Cl IDENTIAC�— COMMERCIAL
as s
SOUTH
I hereby, certify i> !nation, submitted
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT 4 PERM.�7.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
▪ Heating Permit
70
• Sewage 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
tzs-
Your street address will be
-2L
DO NOT WRITE BELOW THIS LINE
Sewage Permit Number Issued Building Permit
Remarks
The zone is
Receipt 7927 Issued
Form 523 Blda. Code
E.N.A. APPROVAL ONLY
SPCA. CO.HEALTIDIST.
HEALTH DIST.
1.4.1975
ENV. EAL H
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