1975, 06-13 Permit App: L0490 Residence•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 9920
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
Name of Owner m Al- K t n s Address R O. R D$ I-10 Cd Phone clog -1 703
Architect Address Phone
Engineer t 1 Address Phone G t' 7
Contractor Tom P41'&t VIS Rot ROti-44)t, 0 R5,al y Phone 12' —I J 08
Legal Description of Property (Give complete description from deed, tax receipt, etc.) --
Ld-i 3, (3tdccc L4 th`et.,w (.ps ttc4
DESCRIPTION OF WORK: New x Addition Remodel
Size of Lot I (c5, X II3q'
Stories Dimensions r; 67 r X 7c'
Rooms Baths, Basement 100 `In Foundation Const
�p Full, part, none
F:A . Type of Roofing C c M
Heat. System
Use of Bldg.
Moving
Sewage System
Total Sq
Bldg. Zone 1 Fire Zone 3
C epi', �: Const. Fr.
`� I (Fr., Conc.,B/r., etc.) by
421-3_10.
Ft��
Valuation Tdj SOO
Chimney
Fireplace (Kind)
JJ (Kind) i (Number
Ext. Finish Ube!, Q'' r3(`1CKInt. Wall Finish 3/1'd'-trcck
No. of Units _Bedrooms 3
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.
4z
m
to
NORTH
ESIDENTIAL = COMMERCIAL
SOUTH
O fid
I hereby certify information submitted is correct and there are no other
as shown. •
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
C4; ti l s(iy�'
State License No.
c; 3 -DI- 18 059
Ind. Ins. Acct. No.
REQUIRED
Gold Se4,1
Plumbing Permit
Heating Permit
H
Sewage Permit Rnlavla W cik er
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
Your street address will be
Sewage Permit Number
Remarks
DO NOT WRITE BELOW THIS LINE
M --2Y
1175
ate
CONSTRUCTION COMMENCES.
Issued Building Permit
e zone
Receipt 2f2 8
7.5
form 523 Bldg. Code