1975, 03-07 Permit App: K6843 MH•
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 an9
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.
NATER. Wafer supply must be approved by the County and State Health Departments. Where work on water connections disturb%
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
Architect ,
Engineer
C r.
%1 Descr' tion of f.perty Give complet
✓✓✓
a
Address
Address
Address
Phone
Phone
Phone
Address wakm..ati.. P on,,•��rr
iption from deed, tax receip e c)°%jar.`. /A
rA
g /(I /
DESCRIPTION OF WORK: New Addition
Size of Lot
Stories
Rooms
Heat. System
Use of Bldg.
7 -x /fig
Remodel
)(
6
Dimensions O
Baths 2-
Basement Foundation
(Fu J, part, none)- — 1
Ty.e of Roofing ' Ext. Fini h
Moving Bldgs Zone ( Fire .Z�o^1ne 1
Sewage System onst. T "r",.
r Fr., Conc r etc.)
iyooc O r
Valuation
17/1/6
onst mney � Fireplace NQ
(Kind)
Int. Wall Finish
No. of Units/ Bedrooms '2—
hi
z(Numb
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
SOUTH
I hereby certifformation submitted is correct and
as shown.
Owner Agent
A LAND USE OR STRU TORE PERMIT MUST BE 0
THIS IS NOT A PERMIT.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit 161.
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
K -j)
there are no other structures located on this property except
t3-- 9- r7
Date
THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
Your street address will be r / C/ {-2 / ,/) t
Sewage Permit Number Issued /Buildingit, J f',8W
Remarks
40.
The zone is ire -4-,2
Receipt "3111 Issued 3/04—
Form 523 Bldg. Code
4,071- /c7 64,c.k
Eis-0/0