1975, 01-02 Permit App: K6569 Fire Damage Repair•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N 811 JEFFERSON SPOKANE WASHINGTON 99201
0
APPLICATION FOR LAND USE OR STRUCTURE PERMIT (1--),c)'
.;/
GENERAL REQUIREMENTS
PERMIT FEE
PREQUIRED. A
structure
is
cby
ucaslerect
building structure or the
kind or alter any building orstructurealreadyereted, ortohngealand use.Constructionust conform with
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.
leastces, a
25'�isMrePRPERTY LNES. In mostquired, aI5' side yard,z15' side yarrdrfrom acflankingnstreet,sandback from 25' rearhe yardont areprequired.rty line, of at
ones and
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work egress.
mustbe
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
// Address M) �OS- 1) r 0 Phone 9't9 o2,7
Name of Owner T/, Z f b tTN 4/ -ted ,V Phone
Architect Address
Address Phone �1
Engineer rr I if h �45�8*It
Contractor / Nni a Y i Address S� 02 x ��.S S 1 o +J Phone
Legal Description of roperty (Gi a omplete description from deed, tax receipt, etc.) L_5 4/4, . 5.-
%Q' //a ' / ia .�ycd , i 9,42 id ,e,(..., o ' _/!3,0 /02 9 *4.,-z
,DESCRIPTION OF WORK: New Addition Remodel —sem Moving Bldg. Zone / Fire Zone
Sewage System onst.
Size of Lot .‘4)4( `Z 6 (Fr., Conc., Br., etc.)
Stories Dimensions
Total Sq. Ft Valuation ,-.7"dw-
Rooms BathsBasement Foundation Const Chimney (Kind) Fireplace Number
Full, part, none)
Heat. System Tye of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. 1/.4, o/.4, /�""`u cr=y' / • ` "' No. of Units _ Bedrooms
fieLep' 4tp%.-cag..;44-) 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
//„. _
—4aeteP
d. rA
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
n+ Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby . 4 nformation s ,witted is correct and there are no other structures located on this property except
as shown.
Owner or Ag f(
A LAND USE OR STRUCTU ' E PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Date
DO NOT WRITE BELOW THIS LINE
Your street address will be f,2 0 5 v/-st-c-rn-z./
Sewage Permit Number Issued Building Permit
Remarks
The zone 1s
a %r
Receipt Issued
Form 523 Bldg. Code