1976, 10-25 Permit App: L5953 Residence _.,. �-.�.-.y.
Coadnty of Spokane, Washidgfon
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 /i
U/
APPLICATION FOR LAND USE OR STRUCTURE PERMIT( 0;7
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 ith 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 dis9irbs
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.
', ' r APPLICANT FILL IN BELOW THIS LINEG
Name of Owner . _ _�/J . _ -
Address ��. Phone '5���
Architect i Address Phone ..z 3Z0
Engineer y� Address Phone /5:- a 4--(Contractor / 1 a ��L iL� Address ,--2./ a 7 -c, G- Phone 00/
Legal Description of Property (Give complete description from deed, tax receipt, e .) - / 2 _ '� -- L
Yds' l - - Y1 /3 - 0//T- Ki2 - - - 7/
DESCRIPTION OF WORK: New U,'" Addition Remodel Moving Bldg. Zone I Fire Zone
Size of Lot � ' OL /3/ ' Sewage System .S - -- FFrnsConcf , etc)
Storiess Dimensions 4b' 0( �- . ' .-2 •A D y /O - / Total Sq. Ft.�Valuation .3�.3G lj
Rooms ` Baths Basement ff/ 1/ Foundation Const. ('o'"3 ✓--e•1-' Chimney SAS- Fireplace /
Full, part, none) (Kind) ''^^^> (Numbe
Heat. System I Type of Roofing Co rri rj Ext. Finis / Int. Wall Finis
Use of Bldg. A'._ e y %f _ : / No. of Units_Bedrooms 3
PLOT PLAN gidocatioLy te,6„2.2,--,
Draw sketch with dimensions showing: (1) property lines; (2) street or road ns; (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.
NORTH RESIDENTIAL— COMMERCIAL ate is nse No.
d I s. Acct. No.
*II -
REQUIRED
Plumbing Permit
* /212-e Gar-e-cli
in Heating Permit
gm RI
et 62-a " to Sewage Permit
1 1
cJeli-it'
1Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I her certify in��or ion submitted is correct and there are no other structures located on this property exc pt
s shown. � o
,..- 4,
Ow r or Ag"--U
gent Date
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
liii s,
Your street address will beefrj:ci.„...,k /-9'4r/49The zone is _
Sewage Permit Number Issued Building Permit Receipt Q Z_ ssued5 ;
Remarks I
Form 523 Bldg. Code
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