1976, 06-01 Permit App: L4105 MHCinty of Spokane, Wadi-gton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 9920
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 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 citcumstances, a set -back from the front property line, of a
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.
-t 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
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Name of OwnerCtl p' Address Phone
Architect 0, Address // Phone
Engineer �� ) Address / q' Phone
Contractor (�t�.�(/LZ�I"ti Address firEn Weft... Phon G
Legal
gall Des iption of pron. (Give complete es ription from deed, tax�eceipt etc 1 e� - '�
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DESCRIPTION '(:).1
OF WORK: New Addition Remodel Moving- Bldg. Zone / Fire Zone
Size of Lot `). r 7' 1 34.) I Sewage System r/ (oast
Br. )
Stories_Dimensions I 'I X(2 Total Sq Ft 9 b CJ ""
Valuatiiion76/c•"
Rooms Baths / Basement Foundation Const 1 vim' Chimney Fireplace
1, part, none T (Kind) (Number
Heat Systemld!) / i
UType f Roofing E xt. Finish Int Wall Finish
Use of Bldg• �I /i .4.4.-1 a, /C"•`,-.a•-,'--iy_-`a[.'s!_
No of Units _ Bedrooms
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.
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NORTH RESIDENTIAL — COMMERCIAL
irtigad
SOUTH
State License No.
3-42—/3W7
I d. Ins. Acct. No.
V
REQUIRED
Plumbing Permit
w Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
1
rc
reby certify information subm¢tted 1;' correct and there are no other structures located on this property except
Owner or Agent Date
A /r D USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
TH ♦ IS NOTA PERMIT.
(} ma,f2,0 DO NOT WRITE BELOW THIS LINE
Your street address will be / /01 / 7 (n .j
Sewage Permit Number Issued
Remarks
Building Permit
The zone
Receipt
is
Issued
Form 523 Bldg. Code
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,cm's r,A r ,frers�
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JIM OR JACK WIRTH
S. 420 TSCHIRLEY RD. - 926-1140%
GREENACRES, WA. 99016
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