1976, 05-21 Permit App: L3984 MHCanty of Spokane, Wasgton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT als,i
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIREDSA land use or structure permit is required byCounty 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.
WATER. Water supply must be approved by the County and State Health Departments. Where work onwater 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 thestructure 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.
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/��1 D /� APPLICANT FILL IN BELOW THIS LINE
Name of Owner ,1 di if l ,42,„ c
Address
6
Phone 9-2&L a9SU
Architect Address Phone
Engineer,ly1 �-�7 Address Phone
Contractor ,Q(J L�M'tt• Address�/), pp Phone
Legal Description of Property (Give complete description from deed, tax receipt etc 1 /w. ' c,L O TSS ( - 6'301
Lor # (3.CK ( .��4)-8-4-0421 Mactit.J+.,4-14,(4, ..i it,
DESCRIPTION OF WORK: New 'V Addition
Size of Lot /40 Y / d#
Stories '('/ Dimensions /4-x (o6'
7
Rooms Baths / Basement /VA
Full, part, none'
Heat. System /' Type of Roofing
Use of Bldg. ti XI..A'EtCQthe-
Remodel Moving Bldg. Zone _...2-- F Zone
Sewage System Const — 1%
/l
(Fr., Conc.. Br., etc.), O
T tai q Ft 7�0 Valuation �5°0
Foundation Const (.Ate+-�'�+-/ - Chimney Fireplace( N .4
( �,n N tuber
�
Ext Finish L Int Wall Finish '1 AIM,0,
No of Units _ Bedrooms Q
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
RESIDENTIA r COMMERCIAL
au_ a c Agami
SOUTH
I hereby certify inforpmtio sub
as shown. \
-4
N
�}lState License No.
(�.LU�141isL
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
fitted is correct and there are no other structures located on this property except.
4 gun- .s —.Q / — 7 '
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 15 NOT A PERMIT.
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Your
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Your street address will be�(S(„ Q,3 ^ , '%/,Ct/� . ,,LLLL.Q, • "The zone 1s I� .��r(/)'v-(.%/,./'Y.O•Ea-
Sewage Permit Number _ Issued Building Permit j.- 3iey Receipt 11 t(6'l' Issued
Remarks
DO NOT WRITE BELOW THIS LINE
Form 523 Bldg. Code
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