1978, 03-17 Permit App: M5299 Pool 0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 U
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.
APPLICANT FILL IN BELOW THIS LINEr Y/3N� 1,Z�6Name of Owner /-41/1 J?:i puck{ Address �S �� l(9 //-F Phone
Architect Address Phone
Engineer 1 Address _ / 912/6 Phone
Contractor p i7 f'I I Is')e l Gt, /�C 6: Address . 13E LPE"-A& -• Phone Ci,Ag F(7
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number S 4130_
/
I-o r I q 13 k-ir,:_,1 4.,. .h/d_it-A ae.--K___ ii,,LeteLL,
ROADWAY R/W WIDTH ,/
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone ___/_____. Fire one
1
Size of Lot /3 X11C3 Sewage System ,A/ CF�nsConc., B ., etc.)
/ �_/ 1
Stories_Dimensions 7 0OiV(? Total Sq. Ft. d#5 Z Valuation .71/000
Rooms //./+Baths Basement .Ai A Foundation Const. t/1AtY J. d../N�-/e N4 Fireplace NFireplace NA
Fu I, part, none) (Kind) (Number
Heat. System " Type of Roofing Aft, Ext. Finish NA Int. Wall Finish f�/U
Use of Bldg. e((//4-7-cf., LJ;nifVI i/V. "'co/ 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 State License No.
OK DN 1s:..E"
Ind. Ins. Acct. No.
ESIDENTIL-COMMERCIAL
REQUIRED
F 30
n Plumbing Permit
PRL PosEi
P06 m Heating Permit
m
in ` N Sewage Permit
♦ 4 �X/SNQ '
`f I /@EsT/ips,vC5` I/ 'I Plans Received
I Plans Checked
1— Plans Returned
Plans Picked Up
Plans Mailed
9/� ;/;
/ TM A\/, -* SOU H
I hereby c rti fo ti.. 'sub.. tted is c ect and there are no other str ures located on this property except
as shown. ---1 /
Al)
er or gent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be (? %Jews; 6 9it(:-,z-4, aetA _ The zone is C6tAtelf tftlf4e-sititt-
Sewage Permit Number Issued Building Permit Receipt 66 `1' Issued
Remarks
Form 523 Bldg. Code