1976, 10-20 Permit App: L5895 Residence0
County of Spokane, Washin ton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT Oi
GENERAL REQUIREMENTS PERMIT FEE......1....................
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of W
kind or alter any building or structure already erected, or to change a land use. Construction most conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to impaction.
WATER. gat er nupp If most be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Bonds, permission must be obtained from the County hegimer's Office.
SEWAGE SYSM. Permits are required is all cases by County Resolutions Nos. 45 -IM W 47235.
SET -RACK 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
,_j.r firmed is accordance with stakes. Points of ingress and egress most be approved by the County Engineeg� saw
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved an a County or State
Higbwar,-Vle.ra.ae must be obtained from the County Spillway and/ar 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 covemats or dedications.
.r ^ APPLICANT FILL IN BELOW THIS LINE
Nam Naof Owner //
.�f/. 2-f 9L SrOr Address ✓ Phone - U
Architect Address Phone
Engineer Address Phone
Contractor Address Phone
Legal Description of Propefty (,Give complete description hum dead, tax receipt, etc.)
/'A2YJ A/ Z2L / -K' —T 3J 1 — —
DESCRIPTION OF WORK: New _IX— Addition Remade) Moving Bldg. Zone — Fire Zane
Sire of Lot 1 9/ SC /J'.2. Sewage System Czo 77.- ppenal
adC Ac! "�f% IFr., Cta c., Br., etc.)
Stories imenaians �// r ✓ / /� r >< 20 r `L_Total Sq. Ft. Valmtion 3-3 Qm'
Roams �mtltk -- Basement l�GL Folndatian Const.. rnn� -- Chi.eY�iirePlece
moll, Part..awl (Number
Heat. System 2�L 2 V Type of Rooting �/7 M D Ezc F{ni sh /C�% �Q'� Int. Well Finish
Useof Bldg. f,/t/r f/� [ ✓ /QCL/OG J!C L //>T /_/P.AfIL /' No. of Unite_ Bedr ms>_
PLOT PLAN
Draw sketch with dimensions showing: (1) property linea; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (S) location of sewage Arm -
SOUTH
State Li a No.
12
Ind. new Acct No.
REQUIRED
PlumbingPermit4.ufa(/✓ AVN
Heatin&j
g Permit O d U -Z
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Plaited Up
Plans Mailed
I hereby certify Se1W1'Ratim submitted is correct and there are no other structures located on this property ercept
as shown. ! /
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 ,
Tour street address .111 be A7'Y6V /L/(/. GL�ZfEv F/fLy.!/ The
Sewage Permit Number laeued Building Peraft mec
Remerk. Y
Form 323 -bldg. Cod.
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