1975, 12-03 Permit App: L2212 ResidenceNO
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CAntof Spokane, Wase ton
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BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 l�Q
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT 'T
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 LINE 4 V [e
Name of Owner Address
Architect Address
Engineer Address
Contractor Address
Legal Description of Property (Give complqte description from de9d, 1
Z_f_4Z'!i!f-/ ea - s4 / %i 4/ta Phone eV itV " [ ,20 SZ
Phone
Phone
42 Phone
DESCRIPTION OF WORK: New _ Addition Remodel Moving Bld . Z p`p, _ /— Fi Zone _
Size of Lot -70K136 I Sewage System Cons . 4� Pons
Conc., Br., etc.) �i
Stories Dimensions �'`f x� '� 9O0
Total Sq. Ft. Valuation
Rooms 6 Baths Basement Foundation Const., Chimney ry 'tip Fireplace 2
Full, part, none)vc��.[� (Kind) ,(� (Nu ber
Heat. System .Type f Roof' Ext. Finis Int. Wall Finish 6
Use of Bldg. No. of Units _Bedrooms -�
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings;
tem and water SUDDly lines.
(3) location of existing and
(6) location of sewage sys-
AMERCIAL
State License No.
K -6/V -Fig
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
re
Heating Permit
NSewage
Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I here ertify inf tion submitted is correct and there are no other structures located on this property except
as show
'40
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT. / 1 J) `
44, 1 DO NOT WRITE BELOW THIS LINE
Your street address will be `� d> The zone is
Sewage Per" Number Issued Building Permit °-_-teceipt Issued '
Remarks,//l
Form 523 Bldg. Code