1973, 03-14 Permit App: K810 Residence 1111 ill
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT / amu
GENERAL REQUIREMENTS PERMIT FEE 4,_
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any 4
, 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 Owne Address Phone
Architect one Engineer ore--p at C N� ft Ake?
Contractor a �A. g , C'��.CM 144 Al►� .essA3/$ 044;4 4l ei Phoneto,-I /
Legal Description of Property (Give complete des ription from deed, tax r ceipt, etc. i� ��ft'/ /{/ O/�' e /V
or *tit Se /y AP G sW iv Qf 7 .c e' t/t 0.JCf moi`®a,,�a 7-0.40'4i�wis
N-4 +/ - a — a I I N . mVe A i
DESCRIPTION OF WORli:New Addition Remodel Moving B� Z./one / Fire Zone
Size of Lot 4.12 q,. Sewage Systerrefe,/it Tee t Slries
Const. ►,A.e Dimensions J) r , Total Sq. Ft. f,•./ 9 Y Valuati JJ'0 DG "
(Frarrlllle,(5 1T rete,bri )
Rooms 4 Baths� asementti/ FoundationConst. Co.,cite Chimney �4*_• Fireplace Og
part, none) ("' (Kind) (Nu ber)
Heat. Syste ype of Roofing e ,• Ext. Finish Ldp ./ l�l r'! , Int. Wall Finish,f`it�C `
/�/
Use of Bldg. Ref, Cie.'C e l No. of Units / Bedroom
Garage or Carport Attached Y CIA n'"Prke-Ii ed Private Detatched
VPLOT 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.
A4NORTH KState License No.
Ind. Ins. Acct. No.
d
4 y %, REQUIRED
Di /So "� J Plumbing Permit
in
Heating Permit
�GD9 - - - �. - 0 H Sewage Permit
Or ..
2'' Plans Received
V rt
Plans Checked-
Plans Returned
Q
CO .t - iI
' eitti Plans Picked Up
Plans Mailed
5 UTH
I here certif inf on submitted is correct and there are no oth structure located on this property except
as shown. ` � js i `
y�„" cCC Date "/�3 •
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
' / / / /
Your street address will be /6 . , .4 ....414.. )—_,A,� d i .e zone is i' 1
Sewage Permit Number Issued ) Building Permit 6/O Receipt 61.5i Issued
Remarks /yl
Form 523 Bldg. Code
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