1976, 11-10 Permit App: L6278 Residence , 03
County of Spokane, Washington t%� t '
7BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE L
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 _, ..4_ c/y a 4-
.Name of Owner� 4,-,41,1,;L / ,4,/-ii-/. Address (CI 13 `t / ij "' .t �l _ Phone G,J,:''tv-4- t-
Architect Address Phone
Engineer Address Phone
Contractor 5=dA'' 1 i.!d. 4 13,,4c,ti.2. ie.-i.L.L 146-1)-6'al, Addressr j Phone
Legal Description of Property (Give complete descriptionfromdeed, tax receipt, etc.) ,f"% L OF / el:51,Z) G,,-{/ 7
,E-, �, ):(1i . / 4-r_ :; . otiTr> /P_ , , r r� k' f fi• i.
DESCRIPTION OF WORK: New Addition emodel ( Moving Bid �Zo_�n��e- � / Fir one .
Size of Lot G. -�X / �7%= Sewage System k'n�u / a."4,4,‘,
const:
-.t-
Conc., Br., etc.) ,�cl
Stories l_Dimensions Q 7 X Z3 / �' g�0 ilk
Total Sq. Ft. Valuation
Rooms Baths / Basement-�L- t.- Foundation Const. (...):_4_,v,/:>4
�S L��ti 'i'`� `t'' r�
Full, part, none) f' Chimney/ Fireplace 1"" "':�" `
(r y (Kind) a _ (Number
Heat. System 1(),� /=A, Type of Roofing 0,e1-1.40,e1-1.4,40...,1 .., Ext. Finish ne,4�.Sz'Jt G:1� v Int. Wall Finish (- u't-
Use of Bldg. ,A,2„4„,..,,
,2„ aeL'(.G t e, ( / ' - _ (.t ) No. of Units_Bedrooms w
IteD PLOT PLAN
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 sewage sys-
tem and water supply lines.
NORTH RESIDENT-COMMERCIAL State License No.
0:"..a-kelt--
Ind.
:".d t-rtelt--
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
m a
N N Sewage Permit
-I -4
'pyo p,,,.=, ,, i Plans Received
/ter , ??FaJDivC,t`/ 0 / Plans Checked
•' Plans Returned
Irl Plans Picked Up
q Plans Mailed
4/ T11 /At./ SOUTH
I hereby a tify informatio )sub iu tted is correct and there are no other structures located on this property except
as shown / , /Q--/--- 7
Owner or Agent 2 Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(34.4 741.4 2 DO NOT WRITE BELOW THIS LINE
Your street address will be e % // 4,,t.ii r.2 rc$._ The zone is (0' ../.4r e�ya
Sewage Permit Number Issued Building Permit _.2 1 Receipt 4. 5/j Issued
Remarks ,
•
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Form 523 Bldg. Code
REQUEST FOR SEGREGATION
i
Name e✓e),_ K. Sc-A Llt i _ Address /D9/ --2,J X4 ,4
print
Phone No. JG
uv=--P. —0 Parcel No. /9_57_57-6.Se/
Date ji1d74 ARE TAXES PAID? yrs.;.
Enter ne legal description ( s ) desired. Use supplemental sheet if needed.
o
Lf 7 a40( Lo1`g eg ,z, �l
ill v
Z S' ' k) 4 er- ' iS 130 , L 8
Make drawing of entire property, indicate segregation, show all demensions of •
property lines, show ell buildings and indicate distances from property lines.
If a copy of survey is available attach to this form. Use supplemental sheet
if needed.
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