1976, 03-12 Permit App: L3138 Residence Co._..fy, of Spokane, Washi. fon
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT A t,
GENERAL REQUIREMENTS PERMIT FEE._c..) (.)
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.
iCOUNTY 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.
iMOVING 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,ry,r/ (if,75/ _J/7 • Address ,' '&-",,ej f'� 7 f� XPhone 3-j-2 '2-2.2
Architect 3 Address f Phone
Engineer Address Phone
Contractor �r 7 -.1,1Y= Address 5.-2 ill �' Phone ,7"...,r7 -"/ f`'
Legal Description of Property (Give complete description from deed, tax receipt, etc.
4.074 / iq/oe t l f d4-C-Zi Ati'ycCttil 7yi/ -/tO t
"--/..,,J/ z/,F w 5f e.-
DESCRIPTION OF WORK: New "'Addition Remodel Moving Bldg. Zone , ^ Fire Zone ..._...../____
Size of Lot _ '5 ,(/ 3c) Sewage System - -' '// onst. 1�''-
��r j (Fr., Conc., Br., etc.)
S ries�Dhmensions vV- -5 ,X -3 ` ' 7 J(%t/� otal Sq. Ft. &� Valuation e3'Tj ,.1cr '
Res 5 Baths / Basement U_.1 oundati Const. ,c,11 C Chimney — Fireplace
(Full, part, none (Knd) (Number
Heat. System,' , -i(t't Type of Roofing GrC.-�� Ext. Finish` -5i4,/, Int. Wall Finish e://4-.) '-'--' //
Use of Blgg- F'c i c:�i E' 1 a.l,�o • i,.,., ,/,.>. -,...r .44....e1.-1-,19 No. of Units 1 Bedrooms _
PLOT PLA
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 ew: :e s•s-
tem and water supply lines.
NORTH ..-_, State License
(:::(-d • ii�
/A _
I .. Ins. Acc . No.
974 C
i
` / l
, (i, REQUIRED
(A Plumbing Permit To/4,
m `,
r� in Heating Permit a,6 Jel— e;e;ggG%
to N Sewage Permit
Plans Received
Plans Checked `
Plans Returned
e
Plans Picked Up
(( Plans Mailed
�1 SOUTH
I hereby certify
certify information submitted is correct and there are no other structures located
_ onn this property except
as shown. L" - C ;yr1G � `ver/ -. %/F
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Y-y,4� ,q DO NOT WRITE BELOW THIS LINE /
Your street address will be 3 )c2 .7 _<, L� d.
CR� ,t -- The zone is -A /- / r
Sewage Permit Number Issued Building Permit /_Zlir.5- Receipt ® ',71?) Issued
Remarks
Form 523 Bldg. Code
I
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