1976, 06-09 Permit App: L4240 MHC ty of Spokane, Was ton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKA' IE, WASHINGTON 99201 �x,J J/
APPLICATION FOR LAND USE OR STR'1JCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FE _0 __
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PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of auy
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. Vhere 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.
���II APPLICANT FILL IN BELOW THIS LINE
Name of Owner tax' 1 �y Address PT Phone Sam
Architect Address
Engineer Phone
��� Address Phone
Contractor _ Address Phone
Legal Description of Property (Give complete description from deed, tax receipt etc.) -/ — 6,�(0p
DESCRIPTION OF WORK: New _ Additio Remodel
Size of Lot Sd C �� /� ' k
Stories-2—Dimensio`ns
i
*Rooms Baths J Basement //�__ Foundation Const.
Full, part, non,—
Heat. System Type of Rooli y I
Use of Bldg. LV vu q
Moving Bldg. Zone I— Fire Zone T[
Sewage System - efi c` Const., 4 V- il- 71rC ,I.
(�� `Fr., Con B� etc
�1Total Sq. Ft, �lq
aluatio
ChimneyF• lace
/�/ (Nrb r
Finish 19-1 Int. Wall Finish �-1(_
�Q- LLe_q- 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 ar-d streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
State License No.
C U/1-.
Ind. Ins. Acct. No.
on this property except
vwuer Or Agent J
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
Your street address will be _ / l + �,� q �j ,� v-ui2v411
Sewage Permit Number The zone
Remarks
Issued 4 Building Permit'//Receipts
_ �
Issued
A