1975, 02-21 Permit App: K6764 Residencef � •
County 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 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
� Y ri e 3?tom Phone i3 lag?
Name of Owner O/ty Address
Architect ( Address Phone
Engineer , Address Q Phone
Contractor +4CJn R. eaP,�..A Address 9.jc 7 5 I1 Phonne
e,70,a
Legal Description of Property
(Give comp to description from dee tax receipt, etc
?o-. )
v� / 3 / -. 1 V' -� & i r3 'e' cJ
53'/.a3a(
DESCRIPTION OF WORK: New 1 Addition Remodel
Size of Lot /0 j _ (7 3 — Sa 6 — / c3 G
Stories Dimensions '' a "a- �C /—
Rooms _ Baths —�_ Basement n lr Foundation Const
n� (Full, part, none)
&
Heat. System /& / 4 Type of Roofing C 0 J) _ _E2:07
Use of Bldg. I1.n—,. �� ct2 cc.
c o
Moving Bldg. Zone / Firer Zone 3
Sewage System i5 t 3,`i a Const.
(Fr.Co/p
, nc., ., etc.)
Total Sq. Ft /..4**') Valuation a9� Q�d
n C J' et & Chimney Fireplace
(Kind) �//(Number
sh 1 — / // Int. Wall Finish P, i. - 42' �/
No. of Units _ Bedrooms `3
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2)
proposed buildings; (4) distance to property lines a'id streets;
tem and water supply lines.
NORTH
viiSSi on
11eT ! , /1, S h, A% iC✓Qs'e J•i e n
street or road locations; (3) location of existing and
(5) dimensions of buildings; (6) location of sewage sys-
g0 A
ri
16 pesid��
/0,
SOUTH
I hereby certify information submitted is correct and there
1_1
as shown. ig c• -,,,a4;„,
�1 Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
State Li ense No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
rw Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned -
Plans Picked Up
Plans Mailed
are no other structures located on this property except
2! -'JS
DO NOT WRITE BELOW THIS LINE
Date
CONSTRUCTION COMMENCES.
Your street address will be (6) /4 . /
Sewage Permit Number Issued Building Permit
Remarks
cosy_
,444
The zone is � r�
(/►�
'Receipt 1:14 Issued
'7
Form 523 Bldg. Code