1976, 06-01 Permit App: L4292 ResidenceCntY P of Spokane. Wase9 ton
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 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 civi action. County Officials can not bring action to enforce covenants or dedications.
Name of Owner
Architect
APPLICANT
ILL IN B y W THIS LINE
/+ n/ - iLt Phone `� � =�Z� o2 -Q
11�d"dress
Address Phone
Address Phone
Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc) 3 `"02i
Engineer
Contractor
DESCRIPTIONOF WORK: New /\ Addition Remodel
/5<L 5( �JrrAAC r
Stories Dimensions L� x �ci
Rooms Baths y
Size of Lot
Heat. System
Use of Bldg.
Basement �J=lldd
1, Part, none
Type of yoofing
? alt A
Moving Bldd Zone
Sewage System .,, / const. FT/1-
c Fr., Conc., : r., e c.) i)
/4/ 6( / 7z.) TQtLSq. Ft -- "''. - uation
F' ndati n Const l -e ¢its t Chimney ) '= /- Firep. e /
-7/ (Kind) (Number /J//
iE _ Ext. Finish '- kf Int. Wall Finish x
Fire Zone
OT PLAT ai `" `
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.
No. of Units _ Bedrooms
as
NORTH
ESIDENTIAL - COMMERCIAL
SO
State License No.
e.23 -a/- a/ 5Y/
Ind. Ins. Acct. No.
6-y-'>
REQUIRED
Plumbing Permit /r/
L>
m Heating Permit //
aSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ereby certi inf• ,:t n sub '•d is corret and there are no other structures located on this property except
- � ti. ( - 7
Onnee or Agent
A LAN
THIS IS
Date
E OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
T A PERMIT.
DO NOT WRITE BEL • W THIS
Your street address will be
Sewage Permit Number
Remarks
Issued
Building Permit
E
The zone is
Receipt LI /251
ued
Form 523 Bldg. Code