1973, 04-27 Permit App: K1453 MH• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
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 spy 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 most be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Reeds, permission most be obtained from the County Engineer -s Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions New. 45-133 mM 49235.
SETBACK FROM PROPERTY LINES. In meet sones and under most circumstances, a set -back from the front property line, of at
least 25' is required, a 5' side yard, 15' aide yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance most be obtained pertaining to set -back and ingress
and egress.
COUNTY ROADS. Work an 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 sad egress most 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 Comfy or State
Highway, clearance most be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds• etc.) require a separate permit.
RESMIC IvE COVENANTS. Builders should check provisions of covenants or dedications Bud assessors 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 ddress -J 7119 J2dd= AJ Phame 9.2kd 28%
Architect Phone Engineer Phone
Contractor Address Phoga e
Legal Description of Property receipt, etc.)
DESCRIPTION OF WOBK: N9. X M,IHIon _ Remodel _ Moving _ Bld yZone — Fire Zone
of Lot 06 6'l Sewage System Byg.,(!41J LZ -Stories
% imensions Total Sq. Ft. i�G Valuation Id'604
(Frame, concrete, brick, eta) �T
Rooms%� Baths �6 Basement Foundation Const r`�at-�r�A�f�f// Chlmney — Fireplace =
_ (Full, part, none) (Kind) (N be
Heal. System p T�y(yp/g of Roofing Ezt Finish�A Wall Finishers
Use of Bldg. d.'.4( _k4-.-tQ-'2 vL/L ��'��i✓/'F No. of Units_ Bedroomes
Garage or Carport Attached Private Detatched
PLOT PLAN
prow sketch with dimensions showing: (1) property linea; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (S) location of sewage eye -
tem and water supply lines.
NnDTU
State Li .sass No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permlt
Heating Permit
Sewage Parnell
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Melted
I hereby certify iofprmntion aftitted is correct and there are no other structures located on this property except
as shows. ) 1� // 1
Owner or A42nt ;/ Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT. ^,
e,,&" y,221 �/L'Q� DO NOT WRITE BELOW THIS LINE
Yaw street address will be t/ G .�.
Rewage Permit Number Issued
Remarks
Form 533 Bide. Coda
zone Is '+'+
jkt2ZOT Issued