1976, 08-12 Permit App: L5136 MH County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 3
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.
rAPPLICANT FILL IN BELOW THIS LINE
Name of Owner ( ;�a i..i d e Ell ; 7` 1 Y rt Address gaol F ePhone , CU
Architect Address Phone
Engineer Address Phone
Contractor Address Phone
Leg I Description of Pro�erty (Give complete description fro deedd,, tax receipt, etc.) `*`" �4.4c,5- - C3?®3
!o.r 9 /�/v c k .� s J2/�1cc� c� ��J` X/e'dl/e
DESCRIPTION OF�W+ORK: New y Addition Remodel Moving Bldg Zon Fire Zone
d
Size of Lot O X % S �/ Sewage System G Const.
Br., etc.)
Stories _Dimensions I Li/J 7e) y� Total Sq. Ft. Valuation /a L'(7(?
Rooms -5—Baths / Basement Ale Foundation Const.. /.J/Gk..-< Chimney Fireplace
(Full, part, none) ,,/ / (Kind) (Number
Heat. System Ed/f'G. Typ of Roofing /`1'7 Finii h `-et 7cr Int. Wall Finish
Use of Bldg. �e_ OiS /< f .'/�� 4 No. of Units_Bedrooms -2-
PLOT
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 RESIDENTIAL-COMMERCIAL State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
N Sewage Permit
-I -e
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify informat' bmitted is correct and there are no other structures located on this property except
as shown.
Owneroror Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
("Ax_ d44/ar DO NOT WRITE ELOW THIS LINE
Your street address will be 757 J /1" e«' The zone is /r /11/
Sewage Permit Number Issued Building Permit `/3(. Receipt 's f t Issued
Remarks f�
I
Form 523 Bldg. Code
Jro 9 13J6c k 2 nwwoD Hai& J4m LI"-
3505 iV Vt7ax
VELOX
$D,
•
IPA
Iti-V
ATE
wer
/6
FIS -'9— iz
'o
Ay
7