1976, 09-24 Permit App: L5611 Residence County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, 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.
I 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. p
SET-BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set-back from the front property line, of at 1'
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 (EAJ/E / n1F.CN �C Address P..0 SCE/C?-90�J�/�.L Phone 92g-1 99j
Architect Address Phone
Engineer ^ ,- Address Phone
Contractor y4►) ')4 t ". 1 _) Address Phone
Legal Description of Property (Give complete description from deed, tax rec etc.)
Icor /01 84k /, n,ri o,J,
(!,oc,t. )7-4) of 5P i GI/ 1" of 1A1.
DESCRIPTION OF WORK: New ) Addition Remodel Moving Bldg. Zone / Fire Zone 3
Size of Lot Qr!o K 12S( Sewage System 57 Const. ,, m
'/ (Fr., Conc., Br., eettc )
X 2
Stories Dimensions 3 Y , e
9i4ccK- �2 D Total Sq. Ft,/S-s� Valuation o qcal
Rooms 9 Baths Basement uIL Foundation Const. Chimney 11t fireplace ADDAX
�--yy�� (Full, part, none) //� (Kind) (Number
Heat. System 6/O6 Type of Roofing (�&/')P Ext. Finish G0DO p Int. Wall Finish Del,IAi ��—
Use of Bldg. ���i prt/�-(. W!�N lARA ct. No. of Units Bedrooms 3
\J 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.
233 -dl
Ind. Ins. Acct. No.
/T9 - 72
REQUIRED
_
Plumbing Permit In U ELLE Q
m Heating Permit Fb11K.0
e
N N Sewage Permit c.a_c_.e. PL) A
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no of;r struct res located on this property except
as shown.
C66)1)/6 / q. I 5 'i .may/Vce,
Owner or Agent ate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFO E ONSTR \ TION COMMENCES. L
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be /6-4/iGa it '2f'4The zone is = JAL_
Sewage Permit Number Issued Building Permit 1v 'f'( Receipt Issued
Remarks
Form 523 Bldg. Code
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