1978, 08-14 Permit App: N0120 MH0 y 1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N.811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMI44
TS ab—
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-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 OP 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.
''��,yAPPXLIICANT FILL IN BELLOW THIS
UTNE L ,•� %9D 14,
Name of Owner -Ike 'Nita e�� 1 t Address L(L' '+O 6-!'�p�J%{ Its Phone 9.a2 . )1q
Architect
Engineer
Contractor
Legal Descripti • of Prope (Give com• late description from deed, tax receipt, etc.)
Address Phone
Address
Address
9210t0MA..C.J[)„J Phone
0 r ( Phone
tip.�"
/-7--/PrO`L
cel Number
9?/' II
DESCRIPTION OF WORK: Newer {`xx Addition
Size of Lot 70'ey 1""• v �X /5/6/
Remodel
Stories Dimensions ��X N•
Rooms Baths Basement —D 'Foundation Const
Moving Bldg. Zone
Sewage System t ConstteAtan re
Chimney " Fireplace sea
Fire Zone _
EveertfitieTotal Sq F
JJ Fu 1, part, none) A
Heat. System Li� 0 .4_f Roo _'_ky��L� Y xt Finj
Use of Bldg. Gets ///B�'r /[T/"o-vi`_' ad. ct_
PLOT PLAN R
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.
Fr., onc., Br., etc.) gO
Valuation /3 ��
(Kind) (Number
Int Wall Finish -4.11-12-1.,4-'
No of Units .Bedrooms /
NORTH
I he
as shown.
SOUTH
State License No.
0.1‹ b (tyt.
Ind. Ins. Acct. No.
RESIDENTIA} COMMERCIAL
REQUIRED I/
Plumbing Permit 00 1< •
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
IV/C/78
K
ertify information submitted is correct and there are no other structures located on this property except
-y-ri iso -77
Owner or Agent Date
A LAND U3't OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOTA PERMIT.
0 4G;ipt DO NOT WRITE BELOW THIS LINE ryl� / //
Your street address will __beee /7 / it c�(1 oj(_Q� The zone is �e,a • //!B4-[.te. dark;
Sewage Permit Number Issued Building Permit Receipt .,7..3 y 7 Issued
Remarks
Noma
form 523 Bldg. Code