1975, 03-19 Permit App: K6997 MH•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 ett
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 041
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of ay
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 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
formed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
G OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
ay, clearance must be obtained from the County Engineer and/or State Highway Department.
ESSORY 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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APPLICANT FILL IN BELOW THIS LINE
Name of Owner Rob et* 4 au LJ 5 Address ,3 /0 A/, Ewes /t a / O Phone 9d V r
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Architect Address Phone
Engineer Address Phone
Contractor Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) / t't / Slot IC /
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DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone �_ Fire Zone
Size of Lot IR, B` 7 )( l/0 )( into, fro Sewage System Ce ric 1,Consttg 11' Mere /
Fr., onc.,,Br., etc.) 7
Total Sq Ft 7Q6 Valuation ooc
Chi eyte' Fire lace 'UV
Stories 1 Dimensions /a x L- 0 )
Rooms Z/ Baths Basement 0 Foundation Const v�/C cK
Full, part, none)
Heat. System f-• ' TypeAL, # II Ext Finish N11--i-,L j
y of R fing
'6se of Bldg. e, /D_'c e (rA 4) [toot.)
mn (Kind) A (Number
Int Wall Finish . -€ I 4
No of Units/ Bedrooms 2
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-
tom and water supply lines.
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NORTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
rw Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby ertify informationsubmitted is correct and there are no other structures located on this propprty except
as shown.
Owner or Agent
Date
.5/,,/7 S
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS HOT A PERMIT.
0/14./ -7/1 00 % DO NOT WRITE BELO THIS LINE
Your street address will be / • +' a '5 EO % ' 1 / The zone is.O-u-C_ [,r
Sewage Permit Number Issued Building Permit &' gg Receipt 9133 Issued i /•.z'a/7'.
Remarks
Form 523 Bldg. Code
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