1974, 04-08 Permit App: K4184 MH — WhVliwoor
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT l/) `i/
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GENERAL REQUIREMENTS PERMIT FEE o
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 " l./ ado ,
.e. Address 8' 5 ,a__ , Phone%,7 q5/1O
Architect Phone Engineer Phone
Contractor 40.,,ry.-e, Address Phone
Legal Description of Property (Give comp ete de criptionfrom deed, tax receipt, etc.)
DESCRIPTION OF WORK:New I Addition Remodel Moving Bldg.Zone '}- / Fire Zone
Size of Lo 75'X /a5' Sewage System, 1 7' Stories
Const. Dimensions 1�)(6L1 Total Sq. Ft. Ai Valuation yQc'o.
(Frame,concrete,brick,etc.)
Rooms —Baths_L___BasementFoundation Const. f- � � Chimney Fireplace
—
_ (Full, part, none) (Kind) (Number)
Heat. System Type of Roofing 7f� Ext. Finish Int. Wall Finish '—
Use of Bldg. /1�CYsc-ct",w,.e. RL-Q No. of Units I Bedrooms ,V....,
(\ Garage or Carport Attached rivate Detatched
PLOT PLAN 4r2...d...-e_-cer-,-(—� tsz_42,
/ Draw sketch with dimensions showing: (1) property lines; (2) street or ocations; (3) location of existing and
osed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
i/
m and water supply lines.
NORTH Stat License No.
Ino. Ins.'Acct. No.
JT REQUIRED ``
Plumb it
in Heating Permit
on to N Sewage Permit
-I -1
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
a. shown.
0 J „ t I ' -
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(5-, ak) DO/NOT WRITE BELOW THIS LINE
41.1/Your street address will be /7 - ( i The zone is kd / 4
Sewage Permit Number Issued Building Permit•('/fie/ Receipt S6`,j Issued C7-//- 7/
Remarks
Form 523 Bldg. Code
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