1976, 06-20 Permit App: L4435 Residence Cudnty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 p`,
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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.
I 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
`c. 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
Name of Owner _ . -R V 'I Address 1 3 g 0 ),'Y3 Phone 's 3�S
Architect Address /day d—s, -Z1/,Z Phone `'/..7 99O
Engineer Address P 3, 3.s— Phone
Contractor S Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
� a / ,1 te/a c o y /moo R P /0,w_s_ 3 3 "/ f t'
DESCRIPTION OF WORK; New y Addition Remodel Moving Bldg. Zone / Fire Zone
Size of Lot j /`/ y 10 Sewage System 5907 6 Const. J=1-•;71"/ 'e
c"'")/, / 4>y1/ (Fr.. Conc., Br., etc.)
Stories Dimensions 34 Xs / Total Sq. Ft.c�/Od' Valuation
Rooms L Baths .2 BasementK // Foundation Const.. C 0 e A 1 7. Chimney 11,"/e% Fireplace 2
(Full, part, none (Kind) (Number
Heat. System if /.7. Type of Roofing S 4 /9 k-t Ext. Finish I' ). "/ Int. Wall Finish /7''‘4/ 0-1i7 1/
Use of Bldg. Pei rv7 4 -+' ,ni/-zc ./ a A4'Nxg, No. of Units/Bedrooms
(4 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 acd streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH KESIDENTIAL—COMMERCIAL State License No.
Ind. Ins. Acct. No.
REQUIRED
r r
I Plumbing Permit I J
tiv
m Heating Permit ‘4'57
to Sewage Permit C l7 e4 N,6;V-
-I -a
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby cert nformation sub ted is correct and there are no other structures located on this property except
as shown. r;sub ted
Owner or Agent Date
A LAND US- OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Tour street address will be /1 d ;47 , , CII L' tt' The zone is L .� Cligt
Sewage Permit Number Issued Building Permit/Jt.(3s Receipt // ' J Issued
Remarks
1
Form 523 Bldg. Code
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