1975, 11-03 Permit App: L2066 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT oo
GENERAL REQUIREMENTS PERMIT FEE ....//0 .............
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
Higtway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
REST�UCTIVE 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 r�
Name of Owner '-1 4fldress _ r l�'"iz ri.�'s / Phone _LRd " 72
Architect Address _ Phone
Engineer Address _ Phone
Contractor Address - '• -- Phone J
Legal Description of Property (Give complete description from deed, tax receipt, etc.) �6 S - ��/ -/ jeo )
DESCRIPTION OF WORK: New _� Addition Remodel Moving Bldg. Zone Fire Zone
Size of Lot 3o 0✓ Sewage System �J;✓itwal Const. _f'e,-
$�I i f t'►1 tKly (; c .c, (Fr., Conc., Br., etc.)
Stories Dimensions -S rC �h 1' 1/ l� 'fi Total Sq. Ft. % ✓ 0,0 Valuation di-' - : C'L
Rooms- Baths t Basement , Foundation Const. fit°// 4. Chimney_y/ Fireplace
(Full, part, none) — (Kind) (Number
Heat. System 4-4 EC F.. 6. Type of Roofing C )A Ext. Finish L+ -1L Vb L.04 Int. Wall Finish dk u
Use of Bldg. /�t_S '�L9�[ ✓ Gtrc�C. 1 7tins;
. of Units 1 Bedrooms �—
PLOT PLAN Draw sketch with dimensions showing: (1) property lines; (2) street or road o (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 suDDly lines.
NORTH
SOUTH
State Li No.
Ind. Ins. Acct. No.
REQUIRE
Plumbing Permit
M Heating Permit -�
a
N Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up f
Plans Mailed
I hereby certify informat' submi ed is correct and there are no other structures located on th' property except
as shown/ s > 1_7N'/ /
r/ ner or Agent Date / `,l
A LAND USE O STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
Issued
DO NOT WRITE BELOW THIS LINE
Building Permit
The zone is /"' 4
Receipt /l� �Issued
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