1978, 01-23 Permit App: M4622 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT Cie)
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 —1
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.
t NATER. Nater 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 47235.
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 y -q'7 -P 46
Name of Owner. C - L4 L'S Address -i �` [J -.� Itek;— Phone
Architect Address Phone
Engineer Address Phone
Contractor 51�q .rn'E: Address Phone
Legal Description of Property (Give complete description from deed tax receipt, etc.) Parcel Number
,4 c,' T '-/ AA/ 0 L, / '/' X C> 7— _,!' - . ZL e_ aC
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone_ Fire Zone
Size of Lot 7,1 - i 3 O I Sewage System�S� onst.
fi¢rl.rG "g2,gc� &_K -_ FFr., Conc., Br., etc.) o0
Stories " Zz r_Z y /G' >'' '>— /6 J'J �'. 9.iC
- Dimensions �'� x �, % Total Sq. Ft. Valuation
Rooms _XC Baths r Basement &fe Foundation Const. �oti� -r -
Fu 1, part, none Chimney Fireplace
(Kind) (Number
Heat. System /'" ALg" c Type of Roofing GOiY1 N Ext. Finish'r/L9/14t Int. Wall Finish Z2s_-L2li%c- �-
Use of Bldg.4,i/c; Z_ A- -CA'"i ZZ r /'0X'9CL GL>>?tiL f 6i TT it 9dq Q`4t;'C 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.
(IDV
M
to
NORTH
SOUTH
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
M Heating Permit "/&'t __�iyt ✓M
NSewage Permit %
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereb ce if infoFinati submitted s correct and there are no other structures located on this property except
as shown. N i.�o� /_ / /' . , , _ o
` V Owner or Agent
A LAND USE OR STRUCTURE PERMIT
THIS IS NOT A PERMIT.
Your street address will be II �- I
Sewage Permit Number Issued
Remarks 2 -,LG I I IP 11,
Form 523 Bldg. Code
Date
UST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
.'� 114 A 4
Building Permit
The zone is f
Receipt J: / Sf' Issued
TAX SEGREGATION APPLICATION FORM
(Applicable to the division of one or more parcels of real property into
two or more parcels under different ownerships, also applies to
aggregation of.pa els.)
NAME
ADDRESS /// U �� (✓
PHONE NUMBER'� DATE
G_
DELINQUENT ,)/Q�
TAXES , PARCEL NO(S
I. Enter legal descriptions of all portions to be segregated.
Also
include legal description of portions remaining(use supplemental
sheet if needed).
II. Make drawing of entire property. Indicate approximate dimensions
of all property lines. Indicate on y which portons of propertyany
buildings should remain. If a copof a surveyis available, please
attach to this form.
III. This application is to be completed in its entirety before processing.
NOTE: The approval of this application by the County Assessor or his
appointee shall not be construed as authorizing the division of lands for
on of RCW
the purpo sAoc �sale Thertaxpayertos her 1by tadvised that nol7 (Plat and
segregation
Subdivisif
will take ace until f rm is complete .
t
THIS AREA FOR
RAWINGS.SE BY PPLICANT FOR LEGAL
USE REVERSE SDE IF
DESCRIPTIONS AND
DRAWINGS.
NEEDED.
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