1974, 02-08 Permit App: K3594 Residence County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401 JNI
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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.
RESV'RICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running wk'th the land
whit are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
Ppgzt.1-45-::1-4 APPLICANT FILL IN BELOW THIS LINE
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Name of Owner 0 ♦. /i�,4 Address // Q Phone that '•
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ArchitectPhone ' Engineer Phone
Contractor 1.-i Address Phone
Legal Description of Property ( 've complete descr ption from deed, tic repeipt, et .)
DESCRIPTION OF WORK:New ✓ Addition Remodel Moving Bldg.Zone / Fire Zone
Size of Lot l] X /j�r.4%ti ' 11.4,-33 X i 9 7.044 Sewage System SiPrK. Stories r�T
Const. Dimensions 11 ( X'1.4'. j a . 2,, s.7 go 0 Total Sq. Ft..2.(d 3 y Valuation -t i 450 of
(Frame,concrete,brick,etc.)
Rooms_ aths r Basement Foundation onst. C. Chimney Fireplace
(Full, part, onzi e) (Kind) (Num r)
Heat. System . 4. Type of Roofin Ext. Finish 14 /11 Int. Wall Finish
Use of Bldg. -4401J '41-'' cal ols1 ,4, No. of Units Bed ooms
Garage or Carport Attac d Private Detatched
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.
4 NORTHe License No.
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VW I's. •cct. No.
Cgoik... ( 1,,a1(•11'" Cl171.4.4 442 ijij .
REQU I R�
Plumbing Permit -
m Heating Permit J
m a
4n cm Sewage Permit
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Plans Received
Plans Checked
\ Plans Returned
Plans Picked 1.
Plans Mailed
SOUTH
I hereby certify i rmation submitted is correct and there are no other structures located on this property except
lshown. lig off/ ^'/)
Own or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
'1 -p� E DO NOT W TE BELOW THIS LINE
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Your stre�d`dr�s5 wi�e e zone is
Sewage Permit Number Issued Building Permit Sf. Receipt 5/1 3 Issued
Remarks _ 7
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Form 523 Bldg. Code
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Chapco Certified Construction
41 16110 E. Broadway
'�' Veradale, Wash. 99037
Legal Description: Lot 10, Block 1, Heather Park Addition
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