1976, 07-23 Permit App: L4806 Residencev 0
County of Spokane. Washington
BUILDING CODES DEPARTMENT. N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
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. There work oneater 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-BAPW FRO-Ti'PQOPERTY LINES. In most zones and under most circumstances, a set -back from the front property jigeSql 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 OP 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. Guilders 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 . / Address O Phone 9.�.P- P'<J�6
Architect Address Phone _
Engineer Address Phone
Address Phone
Contractor __,CIACti i
Legal esyriptipn of Property (Give
ed
/ J
to descriptim deed, tax receipt etc 1
0-4 wr
DESCRIPTION OFWORK: New < Addition
Size of Lot /t>> , O k /7 Set" '
StoriesCLo—Dimensions
Rooms 7 Batha 0 Baseme
//1� / Y-/
(Full. part. non
Heat. System(f '( Type of
Use of Bldg.
Remodel Moving B g. Zone / Fire Z e ).3
/0 4.4..)--BaiXaFt -Cons Br., etc.) Q -
6 3d -a 3Total Sq FtValuation 5,3 Vim'•
rt _
ace
(Numbs
%�%. d tion Const
?Min J
'Chimney (Kind)
Ext. Finish — .47/ Int Wall Finish
7 No of Units _B ro6Ms
set or roadilo./otfos- ; Z3ocaf ion of existing and
dimensions of buildings; (6) location of sewage sys-
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2), st
proposed buildings; (4) distance to property lines and streets; (5)
tem and water supply lines.
NORTH RESIDENTIAL - COMMERCIAL
State License No.
Ind. Ina. Acct. No.
REQ
Plumbing Permit
wi Heating Permit
esr Sewage Permit
y
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify infor submitted is correct and there are no other structures located on this property except
as Shawn.
Owner Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
�.v741.1212.0 DO NOT WRITE BELOW THIS LINE
Your street address will be / 0 7 CZ -5-4744"
4
Sewage Permit Number Issued
mania Y
Building Permi
The zone 1e ll
lie Receipt p;%3g1 Ieased
1
met
Form 523 Bldg. Code
Chin10 CertifiedCmlr821 E. 2610 '
Spokane, WA vnos
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