1974, 04-08 Permit App: K4183 MH 11w .MMT Wil. mom,,,iliv-
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT f �i
GENERAL REQUIREMENTS PERMIT FEE
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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-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 Owner / / .•f'' .-or . •ddress SIS ,, "(L�a,44-a S Phone 0;42/S/.111
Architect Phone Engineer Phone
Contractor .S Q- i Address Phone
Legal Descr'rtion of •roperty (Give pim�plete description from d-ed, ,tax rec iptetc.
DESCRIPTION OFAC )(WORK:New V` Addition Remodel Moving Bldg.Zone Fire Zone
Size of L 1, 5 ST
Sewage System ' Stories
Const. 2 g
a-a-A Dimensions /c9 X 4'0 Total Sq. Ft. 7e�G Valuation 5?C1
(Frame,concrete,brick etc.)
RoomBaths I Basement "--•' Foundation Const. C-i3-7t Li.'- �� ,���— Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System Type o�f�Roofin lZ -f&/ Ext. Finish Int. Wall Finish
Use of Bldg. ��y ,, Jed No. of Units / Bedrooms
Garage or Carport Attached Private Detatched ��
PLOT PLAN a e�`'C`-`,c '
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
pro .[ ed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
te and water supply lines.
NORTH State icense No,
nd. Ins. A A . No.
„.._...4, —
77-- --
�-- REQUIRE4:2' D
./ 7
Plum • it
m Heating Permit
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N Sewage Permit
Plans Received
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Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is7/ ,i correct and there are no other structures located on this property except
I as shown. , f '
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Owner or Agent Date
(,:i..---)1
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
6.44 34-14_442-:2 DO NOT WRITE BELOW THIS LINE
Your street address will be — .e zone is @4- '
Or
Sewage Permit Number Issued Building Permit -7/e.j Receipt ,$-(G fv.3 Issued % i7=_77
Remarks
Form 523 Bldg. Code
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WEST VALLEY EXCAVATING
s. 812 DISRMA3N ROAD
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