1973, 06-29 Permit App: K2150 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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GENERAL REQUIREMENTS PERMIT FEE ----------------------------
PERMIT
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PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of ally
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 d��at, S.
APPLICANT FILL IN BELOW THIS LINE , a
Name of owner fF L. fv_ � L'�'1-Address.tT
Architect Ph ne Engineer
Contractor Address
Legal Description of Property (Give complete deript, frp
on m deed, tax receipt, etc.)
A-07- /4 (:?/—/- / D�i�A _ �1 �� i/c_ � /-q,c. f- / 3 q /4ja.6
Phone
Phone
.:5- /i3-/;2/
DESCRIPTION OF WORK: New Addition Remodel Moving Bid . Zo a Fire Zone
Size of t.qt�ZZe Sewage System Stories
Cons�i2LZLd[i f _ Dimensions Total Sq. Ft. / U D Valuation
( Frame, concrete, brick, etc.) /j� n -
Rooms- -6 Baths �_ Basement�Foundation Const. ` Chimney ` Fireplace
i (Full, part, none) (Kind) (Nu b�er�))
Heat. Syste Ty e of Roofing Ext. Finish �_4t-40-74-4&Int. Wall Finish 04
Use of Bldg. 4y, it”Z �p_ No. of Units Bedrooms
Garage or Carport Attached— Private Detatched
PLOT PLAN _4i1 '61 / -7J`'`1:3 — /-Z /-2—
A Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
uroposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
I NORTH State License No.
SOU TH
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
in Heating Permit _
NSewage Permit _
1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
z Q- c -
Owner or Agent Date
A LAND USE OR STRUCTURE PER IT MUST B ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be 9 lJ ] e zone is
Sewage Permit Number Issued Building Perm i Receipt - �' Issued
Remarks
Form 523 Bldg. Code
8K806 R"'film
RECEIPT
Received From
Addres
Date b
79
_
19-_ 18
� 2
Dollars $
ACCOUNT
HOW PAID
AMT. OF CASH
ACCOUNT C) �/
B
AMT. PAIDO� CHECK
BALANCE MONEY
DUE ORDER
8K806 R"'film