1976, 06-02 Permit App: L4159 ResidenceC�nty of Spokane. Was9ton
J p okane
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.
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
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE i' =-c" 6,
Name of Owner y �.- , A-amss,( �.'—.'1- %� / .:r..f� { _✓��� Phone`
i
Architect �� Address Phone
Engineer Address Phone
Contractor Address •; Phone
Legal.- esctiption of Property (GI mplete descripY n fr deed, tax receipt, et '� �� *7 y /��
yD T r,
DESCRIPTION OF WORK: New 1\ Addition Remodel Moving Bld Zone Fire Zope '
Size of Lot Sewage System `_� onst.
�Fr., C� B ., etc.)
Stories Dimensions S'��%<'- Total Sq. Ft. Valuation 69>p'>
�dooms Baths Z Basement Foundation Const. Chimney- Fire ace Z
5�L'Zr, Fu I, part, no (Kind) (Number
Heat. ys em I T pe of Roofings " Ext. Finish �— Int. Wall Finishi"°''
Use of Bldg. c' `�- �'� =L�, No. of Units _ Bedroo s
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; ) location of existing an
proposed buildings; (4) distance to property lines and streets dimensions of buildin (6) location of sewage sys-
te� and water supply lines.
NORTH RESIDENTIAL OMMERCIAL
State License No.
Ind. Ins. Acct. No.
h UIRED
Plumbing Permit
Heating Permi_-«'C
CA y' N Sewage Permit
0
j{ Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby rcertify nformation syl itted is :rZrt and there are no other structures located on this property except
as shown.))
SOUTH
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
our street address will be
The zone ism u
Sewage Permit Number Issued Building Permit Receipt Q Issued
}' Remarks
Form 523 Bldg. Code