1975, 11-12 Permit App: L2063 Repair Fire DamageCanty of Spokane. Wlashigton
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 mast conform •ith 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 eater 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 Yeaq/9/' Tit' E% r• -..-5o act Address /7(0 0 0 %p N Tgff r-711 Phone
Architect / Address / Phone
Engineer tf Address Phone
Contractor �jl/t/Q t� /1A1/./ L.5 Address ants 2l'itS,6N Phone
Legal Description /of P,rty (Give complete description from deed, tax receipt etc 1
J9O' l %–'tg
Iwo /f ifr-eree,
3-o
a
DESCRIPTION OF WORK: New Addition
Sae of Lot O$O' )( 4030'
Remodel
L Moving
Bldg. Zone __/ Fire Zone
Sewage System Const.-
1Fr., Conc.. Br., etc.)
Total Sq Ft Valuation , ,eld�—
Foundation Const Chimney (Kind) yyFireplace
(Number
Number
Ext Finish Int Wall Finish
No of Units _Bedrooms
Stories _Dimensions
Rooms Baths
Heat. System
Use of Bldg. (fn/zit.,
Basement
Full, part, none)
Type of Roofing
0-.ia4nAi
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.
NORTH RESIDENTIAL — COMMERCIAL
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
rn Heating Permit
Me
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify infdrmation submitted is correct and there are no other structures located on this property except
as shown. /
'-«.( ////' /77
Owner or Agent ate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be 11 4 (/ (/ (� 757),(�) The zone is
Sewage Permit Number Issued Build Tag Per it Receipt Issued/
Remarks a u 43
Form 523 Bldg. Code