1976, 05-06 Permit App: L3896 MH 3
COOnfy of Spokane, Wash igton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
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 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.
1 . APPLICANT FILL IN BELOW THIS LINE
Name of Owner /. '''`-- f ' r "--t-1" Address eT 7 ZI 6_ > Phone*5-3 S S- ?_3
Architect Address Phone
Engineer Address Phone
Contractor Address ,� � � /;1 Phone
Legal Descri.tion of Pr�k=rty (Give complete description_from deed, tax receipt, etc.) Z
C , ,_7. 0 ...m.
t
DESCRIPTION OF ORK: New Addition Remodel Moving Bldg. Zone / Fire.Zone
y�
Size of Lot f d I` 2' 8 1 o '4 • Sewage System -3 [ ConstFone et 0- 1-• 5 1
Stories I Dimensions �- Total Sq. Ft. � Valuatio ,
Rooms BaCs '' Basement Foundation Const Chimney Fireplace
Full, part, none) (Kind) (Number
Heat. SystemQ C--c-- Type of Roofing Ext. Fini h Int. Wall Finish 7
Use of Bldg. 41i -_� _' ;��.,, r A _o__-_-.__-.. - . 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.
NORTH RESIDENTIAL -COMMERCIAL State License No.
/� Ino. Ins. Acct. No.
�I�„tttfff/// i...„,,,,,,,, JJ ,�,CL4,"
REQUIRED/
/ Plumbing Permit
m Heating Permit
in � �,,' .�
2 -I Sewage Permit
-i )y—if:, _________—_
Plans Received
1/I G 4---0—(
` Plans Checked
) ' Plans Returned
Plans Picked Up
Plans Mailed
i •
f C(
SOUTH /�
I hereby ertify infor ti,'s su•��• . •d is correct and there are no other structures locate on this property except
a s i /X
Vil Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(-V ,�� Pr DO NOT WRITE BELOW THIS LINE
Your street address will b: _ ._g- , / - w�
.,k --..„.:_-,- --. � � The zone is s��
Sewage Pere t Number Issued Buildin_ Permit , 'Receipt atilfe ssued
Remarks/'� / . l"✓� " . _
-C .�1 ta _. -C-ia Ic=e I. 1 ..1-. - - t t .....,LA
Form 523 Bldg. Code