1974, 11-12 Permit App: K6286 MH• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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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. 45-133 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 / dedications.C
APPLICANT FILL IN BELOW THIS LINE
e.
Phone
Name of Owner ? -I�- !% ' Address
Architect
Address Phone
Engineer 2 -
Address Phone
Address one
Contractor e, 3 ,7` .4 0 ---Ph , D
Legal crlption o roperty ire complete de cripti. .fr.m deed, ax re ipt, eett�c) c 2E., .-
2
DESCRIPTION OF WORK: New Addition
�sd
,!Size of Lot
1
Remodel
Moving
Sewage Syste
BI
ne
Fire Zone
onst.
Fr., Conc., B etc.)
- , �rstl"
►rLl
Total Sq. Ft Valuatio
Stories Dimensions
Ro Basem Foundation ConstZ51.��'^'--kiiJ'�-/himney Firepl
Full, part none) (Kind)
Heat. y emTA
/ Type Roofin• ` Ext. Finish �� Int. Wall Finis
tj
Use of Bldg. /---- 4' ----'e---:2c2 --- =1`� 1 �� - '- `_-'o. of Units _ BedreorTis ry
' Jf C
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) locatiaa���qq of existiig-and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) locatiod�G -seWtge sys-
tem and water supply lines.
(Number fr
NORTH
Sta -_Li
Ind. Ins. Acct. No.
I he
as shown.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
certify information submitted is correct and there are no other structures located on this property except
Owner or Agent
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
Your street address will be '31z-tl 27 r `�/ �� / The zone is C _
Sewage Perini] 6
Number Issued Build. ng Permit �' Receip i ssued �y
Remarks c_.�--
Ld / :2- -- 7
Form 523 Bldg. Code