1971, 09-08 Permit App: J0657 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. 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 an7
kind or alter any building or structure already erected, or to change a land use. Construction mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. 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
whtich 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 PAT'SiemM Address e. lam!/is f aA•ToaY+�r Phone 9Z -
Architect_ Phone Engineer Phone `
MIKE GHASTEK �y�y 1 �'}
Contractor E. 19224 Montgomery Address Phone
Otis Orchard, Wash. 99027
Legal Desc. _ Y . „�. , ••,.••c complete description from deed, tax receipt, ,vett.) -7 nC
L* 1r% /Pock 11 AUi-k1-
Wysz. —
16�
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone 1 Fire Zone 3
Size of Lot 4, 0 K / 0 9 ' Sewage System <<- Stories
Const 1- f1C _ Dimensions 1 a` ii b 8 I Total Sq. Ft. -72.o Valuation
(Frame, concrete, brick, etc.) A'
Rooms 5 Baths �_ Basement 1� a Foundation Const
(Full, part, none)
Heat. System• TyRe of Roofing 0*- Ext Finish
Use of Bldg. A\ [4,�-.i' _ at, '7
Garage or Carport Attached
Iva
G.00s COO
Chimney A 0 Fireplace %V
(Kind) (NVmber)
Int. Wall Finish L
No. of Units Bedrooms 2 -
Private
Private Detatched
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
atkadoeP
SOUTH
I nerebyceYin rmat'on sub�ed`is corr t and there are no other structureseiz located on this property except
as shown. � 66,,((ff /,�
l �p�'
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed •
-s
Owner or Agent 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
Sewage Permit Number
Remarks
Issued
c::X l CI'Q'4be zone is
ing Permit 6 $ 7 Receipt -
d ZtiCJ�;,
Issued 9- 7 - 7 /
Form 523 Bldg. Code
(liffa EltatEl
INCORPORATED
Barker Road and Buckeye
Greenacres, Washington 99016
WA 4-9880