1974, 03-15 Permit App: K3886 MH _ TV _f
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99201
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-or-way may not be performed until staked by County Road Department and work must be
performed in aecerdance with stakes. Points of ingress and egress must be approved by the County EngineOr.
MOVING oF• nuirJIircc_ a permit Is reuulred to move an existins building_ When a huildins Is moved on a Founts or State
Hinny, moms s must B8 ehtaineu riom the C8RRt, ERgiReeF andeuF ';tate Mlgnway Depaftment_
sGGFS`oORY $UTTITNM_ Aocessors buildings .Raraaos, sheds, etc.) renuire a separate permit.
RESTRICTIvR colENANTm_ Rudders should check provisions of covenants or dedications and easements ruining with the land
which are enfai6erihle through divll aetl*n. county Vttlelald In AO briAS ROtl4R tC PUfereu eaveaants or dedleations.
APPLICANT FILL IN BELQW THIS LINE �y�
Name or owner ff 1 f Address • Phune'l" v
Architect phone_Engineer Engineer_,,.. Phone
Contractor Address Phone
l,rgal DPnuript n or Property (Give complete ilese •iption trim deed, tux receipt, etc_)
1
f T2LCg-rte; -- l T =
DESCRIPTION N Ill'WORR: New �`"-*-- Addition w- Remodel Movinz -111dd.zone I Fire Zone
Rico or Lo w �S��s�s sewage system r Rtorios
C(ttlst. ?1-r i Rit]iensi011b v TOtal Sit. Ft. . 3--413 t Valuation P{I
t''' sa concrete,bnd fe -5 jLf�} r
IZooisoflY� 13atAeEaeemn
et ��.., li nun ati6P1 Comet. ......__ CHIRYRE4y - rirQI31 .P��
r�f (Full, part, none) {Rind) (Number)
Heat. Ayetem j .a" . Type of 'oorin ifxt- Finish Int_ vtlarr Finish • _—
Use or 14IUu_ S ar:- No- of unite I IEedroome
f'retrutrc or t',irport Atha-11(.41 Wr unto t)ntntrmnd
PLOT PLAN
6r$w nkOtf$ Wlt$ diM0Adl$Ad $$$W1A6: (1) pl'4Rc"ty linen; (2) street of road locations; (3) location or existing and
proposed buildings; fol distance to property lines and streets: (h) dimensions of huildihen, (6) lonatibn Of 56waeu oyO-
tem and water cupois lines.
NORTH Mimic ',lusting Ni,
Ind. Ins. Acct. No.
REQUIRED
PlumbingPlumbing Permit
• Seating Permit
am„ Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown. 'j —/ 7
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
'741/a10-0 DO NOT WRITE BELOW THIS LINE
Your street address will be /7//7 a zone is
— �r 7 • /\"=4--/A1411-114, L LI_
� F7
Sewage Permit Number Issued Building Permit Receipt_S.�rJ U Issued
Remarks
Fcrrn 523 Bldg. Code
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