1976, 07-16 Permit App: L4741 Residence County of Spokane, Washington ,
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT a-
GENERAL REQUIREMENTS
PERMIT REQUIRE!). A land use or structure PERMIT FEE
kind or alter any building or structure permit is
ory toCouchangesalland nuse.to QrConstruction ect a nmust conform or rwith 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 frog property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard ate required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to wet-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.
• PPLICANT FILL IN BE •W THIS LINE ''
Name of Owner_ G6. . I fkQdress
Architect - Phone �- /11 2
Address Phone
Engineer Address
Contractor - Phone
Address e__ Phone
Legal Description of Property (Give5;40plete description f .m deed, tax receipt, etc.) .1..-
DESCRIPTION OF WORK: New C Addition Remodel Moving Bldg. Zone
Size of Lot if g ' 7—) - / (7) )C /<-/ 7-Y'f Mi"'` Fire Zo `e
('/ Sewage System �� �onst:Co
Stories ' Dimensions if $ �//Q(� Z Z 1 r Fr., Co : etc.) , c�
Total Sq. Ft. Valuation � ' -,`s'
Rooms 6 Baths '� Basement a Foundation Const. ( i -
Chimney Fireplace
Il, part, non ' ` be
Heat. S ste - (Kind)
Use of ystBldType of Ro Ext. Finis ,I ,'- 17 Int. Wall Finish �, (N be
t v/ No. of Units Bedr ms
/ PLOT PLA vZ fi
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-
nm and water supply lines.
-0 NORTH RESIDENTIAL - COMMERCIAL State License No.
�� Ind. Ins. Acct. No.
,04„ iilf
IiiREQUIRED
gjiM111
Plumbing Permit -
m m Heating Permit .4�..'?
0a
-4H Sewage Permit
Plans Received 7/,0..�
Plans Checked / L�
Plans Returned
Plans Picked Up
Plans Mailed
/ SOUTH
I h eby cert fy informat ubmitted is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date 17//7/76
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
6/14, -741,0,141--Z DO NOT OWRITE BELOW THIS LINE
001,
Your street address will be 1l 0 0 V .: C. (�'y-E C ; 'i.,/, / �/
Sewage Permit Humber Issued n The zone is /
Building Permit ---t�� �� /
Remarks (l, �� f �-y 1 Receiptp/� Issued
r
Form 523 Bldg. Code
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