1974, 04-03 Permit App: K4097 MH-- - - -.,� —-. -
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County of Spokane. Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT /t7/
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 mast 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 ,,,, ,j y 4i
Name of Owned'fr (1.(! /¢ ,IL Address s &'15 i'`/ , c IL- i 4-eL_ Phone UX"' 4
Architect Address Phone
Engineer Address Phone
Contractor :<1_ 7 ;- , Address 7} Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) .et/4fi�d ,./.-Af:')..:/` 1t 7/ f
i 1.67-1/, e A..%•(" 7 /'/D it`4yr` ADrD
DESCRIPTION OF WORK: New X Addition Remodel Moving BIdp. Zone _/__— Firs Zone ti�
.�� ""7 ' .')ri ' ,e-, Const. "ei:!L vrL!ci-
/Size of Lot isOi..k /..� Sewage System h. 4 ,
(Fr., Conc., Br., etc
Stories %' Dimensions /fes \ 2n9f I Sq. Ft./ a Valuation 'Gf
Rooms Baths _ Basement Foundation Const. i A"'t.S`..1 ae. 7-4W7.1.-chimney "` Fireplace "-
(Full, part, none) 7n �t (Kind) (Number
Heat. System . 0 ' Ty.�faof Roofing /Y�� .� Ext. Finish 3'YZ Int. Wall Finish �-
Use of Bldg. �0'1� �i J14-i' ��- -' 1!� C Q. 4 No. of Units_Bedrooms
'1 PLOT PLAN %t�
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
pr..osed buildings; (4) distance to property lines ar.d streets; (5) dimensions of buildings; (6) location of sewage sys-
•m and water supply lines.
NORTHState License No.
Ind. Ins. Acct. No.
_�---_ 7I 41l ` REQUIRED
Q \ Plumbing Permit
' m Heating Permit
mT` r,,44 ° cS P o a
— 11 4, ' Sewage Permit
'
c------ A,
ti k mt Plans Received
".V./ • GI
a Plans Checked
Ig 1 Plans Returned
�' 1 (^.'d Plans Picked Up
IPlans Mailed
CT'I°\ SOUTH L i .c.. -
�✓ I hereby certify information submitted is correct and there are no other structures located on this property except
_ ��
as sh y .J (..21. : ,_,.- .—
ror Agent 7 Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(9,14) -14,64iD DO NOT WRITE BELOW THIS LINE
r i �4
Your street address will be (�� —4,1r .ori ,4f . (,r�L.. The zone isi� r xrt.2
Sewage Permit Number Issued Building Permit 0 Receipt,:- `, it 7 Issued (7l 3--2 c7
Remarks
ND T E- .e.444-1, p,cLettAx.c_c.. :;ti--.1-e 2)
Form 523 Bldg. Code