1976, 10-08 Permit App: L5772 Residence Ct•dnty of Spokane, Washungton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 017
GENERAL REQUIREMENTS PERMIT FEE.. rO
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. 45-133 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.
CO! 2Y ROADS. Work on street right-of-way may not be performed until staked by County Road Department and wornmus"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.
APPLICANT FILL IN BELOW THIS LINE f 0l&
Name of Owner E E�nct _ Address 5a 1 c&.K(i Phone 6 f 3?
Architect Address Phone
Engineer Q 2 Address Phone
Contractor Address A$e 3-y_3 Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
(3}-ccaicci Acres
DESCRIPTION OF WORK: New " Addition Remodel Moving Bldg. Zone ( Fire Zoned
Size of Lot / 71) A -2,0() Sewage System ->e''i" Const. 4 v4
(Fr
Con
Br., etc.)
Stories Dimensions Amon -7 X a� p Valuationl, 4-5,6
Total Sq. Ft. �-/�a2 ���F�OU
Rooms 5 Baths L1- Basement LL Foundation Const. (GHc',V Si-e4 1.
Chimney Fireplace
(Full, part, none (Kind) (Number
Heat. System 1 Oveece Type of Roofing 3.0..11- 6....41A' Ext. Finish l'ilAW si 2 Int. Wall Finish Pry00[-4
Use of Bldg. SIu4 Le }0..4,x,1 L'Pc, ' 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 arid streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH RESIDENTIAL - COMMERCIAL State License No.
� K
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
1\" 1-1-war
nr Heating Permit
Sewage Permit
N fA
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown. a
) 7_<.ei G. /- //y ,
Owner or Agent 1
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIAMNOT A,PERMIT
) / _,i DO NOT WRITE BELOW THIS LINE
Yours ee a yl //
Sewage E�"► "`�� The zone is(/-4)7---2A c.�
Permit Number Issued Bu ng Permit Y 5'27 Receipt Issued
Remarks •
Form 523 Bldg. Code
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ED ENGEL, BUILDER Ec.° -Mei
5215 S. CONKLIN RD. l‘
GREENACRES, WA. 99016
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