1974, 10-22 Permit App: K6110 Residence04)
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, 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. 45-133 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.
APPLICANT FILL IN BELOW THIS LINE Ci
Name of Owner �ejO/ C4.7,1,5bI''t• t: Jmn` • Address > //44 Phone ?2 ' I'/6
Architect Phone Engineer Phone
Contractor Address Phone
from deed, tax receipt, etc.)
H2- e—
Legal escription of Property (Give complete des)criition
c 3 0
urA /4 4!li,1 /j -mss v'
DESCRIPTION OF WORK: New Addition Remodel
Moving Bldg. Zone
Size of Lot 7 X I2 X/09' X // U
Const tl7(n, e- Dimensions
(Frame, concrete, brick, etc.)
Rooms Baths Z /1-44/
Basement
- 7XyZ
(Full, part, none) "�
Heat. System L�• h. A'Type of Roofing C c.', it•
Use of Bldg. / t e. -} i de, hC-
Garage or Carport Attached /ili)h t
Foundation Const
Sewage System -S
Total Sq. Ft.
Co r14. ,
Ext Finish
%/_y
l
Fire Zone
Stories
Valuation -.44, `1(..91/4•
Chimney `-lc4 Fireplace I
)14>‘5c1,
�/�>> i (Kind) (Number)
P►' 5 Int. Wall Finish t fr/ 11411
No. of Units 1 BedroomsLL! 3
Private Detatched /y,-,
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.
NORTH
ci
SOUTH
I hereby certify informatiomitted
as shown.
is correct
State License No. /
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit _-5 5z;
Sewage Permit / k cik I^
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
and there are no other structures
nom'.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
located on this property except
2z /97'%
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number
Remarks
/ / 7
e zone is /,y-"
� �y�iYt" �-, •
Building Permit Receipt !. r% Issued
Issued6
•
Form 523 Bldg. Code
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49