1976, 05-11 Permit App: L3757 Remodelant), of Spokane. Wasington
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.
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 -Mend 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. -
y';jFJUNTY -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. ,1
410VING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
F(ighway, 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 '11.-
Name of Owner . ♦IL =�N Address f 71/f /L42tt Phone
Architect / Address _ _ Phone
Engineer Address Phone
Address 4‘.14411.4
^, Phone
Legal Description of Property (Give complete description from deed, tax receipt etc ) P�'ce t6 4K.144_ I 0G(1S7-q`D?qu2
/ 3 £L/z- 4 Mts.- id- Aikt-t-- )
Contractor
DESCRIPTION OF WORK: New ' Addition
Size of Lot 9110 lill b
Stories ..i_Dimensio
Remodel
.012
Moving BI.g. Zone Fire Zgne a -
Sewage System ' CConst.
(Fr., Co Br., etc.)
Total Sq Ft Valuatio .,f ��
r-�('�P { Chimney Fireplace 4 _
(Numb/
/
/.„2 K a -D
Rooms .L— Baths BasementlQ_ Foundation Const
Fu I, part, none)
Heat. SystemType of Roofing
Use of Bldg. 6L/t-GL_
(K. -
Ext Finish T-' - 1 1 Int Wall Finish
rel --r No of Units _ Bedrooms
. 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.
N
NORTH
RESIDENTIAL COMMERCIAL
a P
SOUTH
State License No.
V`thu4(:
Ind. Ins. Acct. No.
REQUIRE
Plumbing Permit
rn Heating Permit
NSewage Permit
H
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby cert fy information s. witted is correct and there are no other structures located on this property except
as shown.
Own Agent Date •
A, A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
77� ' THIS IS NOTAPERMIT. *'
\ .""\. DO NOT WRITE BELOW THIS LINE
Your street address will be q/ e / (i[uLIL .� The zone is
Sewage Permit Number Issued Building Permit ,c7Receipt (31:51, Issued
Rerks
Form 523 Bldg. Code
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