1977, 01-19 Permit App: L6717 Addition k.
County of Spokane, Washnigfon
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT, _vim
GENERAL REQUIREMENTS PERMIT FEE. 3
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 mast 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 enl'rce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
J- J �s� s
' I Name of Owner 2dA7 �) /1.114 j Address ! 0 V'C) 5 Phone
l Architect Address �y Phone
'7 Engineer / Address r� '7� Qe Phone `�
r 'Contractor 2 .(n�(' N`t'ekb-I- iCr Address 9 s • kof Phone COV`"?`"? C 26
Legal Description of Property (Give complete description from deed, tax receipt, etc.) , ''13 olga,
%ert I /illd l 34/jo4 bol - I /ock f, kokv .riti ,.- s./Q,
DESCRIPTION OF WORK: New Addition Remodel // Moving BId . Zone 1 Fire _
q130 .�LCt1"-�_
Size of Lot gr/ X Sewage System -� (Fr., Conc. r., etc.) a .-
Stories- Dimens'ons c,& / Ye 7 Total Sq. Ft. Valuation �y s
Rooms � Baths asement#.3,7 e Foundation Const.. Chimney One Fireplace IVO./t-
Fu I, part, none (Kind) ' ) (Ny�rpber
Heat. System (1t Typ of oofing Cf)`4./) Ext. Finish / / - /1 Int. Wall Finish O
Use of Bldg. / ' i/4 tit .plc! 'e rd CiEwf S- 4 ta'$ No. of Units 1 Bedrooms
pitki1/1 e 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.
o 7/'� ./eil? " 7?
3 a Ind. Ins. Acct. No.
REQUIRED
I Plumbing Permit
t q® Heating Permit
IA .7.1''jP L' t(� N yr Sewage Permit
Plans Received
Plans Checked
i Plans Returned
4 Plans Picked Up
\i,0 Plans Mailed
SOUTH ;;z 5
L.
I hereby cer •fy information su 'tted icorrect an there are no other structures located on th s property except
as shown.
Owner or Agent- Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELO THIS LINE
Your street address will be /0 7 g o 5 j The zone is c9.A.
Sewage Permit Number Issued Building Permit /'7 -7 Receipt "�/-2o Issued
Remarks
-*°
Form 523 Bldg. Code