1975, 04-10 Permit App: K7183 Residence/0 •
County of Spolfano, 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 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. There 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. 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 - -- Addressay1/ ', Phone��'9�'y 7'
Architect Address QQ' a. / 6 Phone
Engineer Address Phone
Contractor S n . 1 • Address Phone
Leal Description of Property (Give com• late description from deed, tax receipt etc ) O 4''V - - '
✓Addition Remodel Moving Bldg. DESCRIPTION OF WORK: New 9. Zone Fire Zone
Size of Lot 6d-- 130 '1 1Jf —`10,
Sewage System S Toast. a
I Fr., C nc.Ar.. etc.)
Stories Dimensions 71' 4, 06' Q1 t Total Sq Ft 0-0 8)7/ Valuation tlC' 000
Rooms 4 Baths Basement F✓/ / Foundation Const (o n r. a re-
-
chimney /56-10A1 Fireplace 'm—
FUII, pert, none 1'' (Kind)' (Number
Heat. System OGS P 17 Type of Roofing /e 0 O 717 Ext Finish r)d'%I11 Int Wall Finish 1n, 4 it, 'r N
�1y
Use of Bldg. ..-Pa. y, gs•.�.y
.a exit—. p No of Units Bedrooms
PLOT PLAN
nee-, dr -re.,...”
Draw sketch with dimensions shoring: (1) property lines; (2) street; (3)
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage Us
tem and water supply lines.
or road local iovs� 3 location of existing and
NORT H2
OU TH
I hereby cer$. ify information. sub itted is correct and there are no other structures located,on this property except
as shown.L- /v 7
? Date
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS N��OOQTA PERMIT.
1/.Lf/ r I'
State License No.
lad. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
y'h Sewage Permit
ti
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
er or Agent
DO NOT WRITE BELOW THIS LINE
Tour street address w111 be
Sewage Permit Number
Remarks
G N(3,25- .y, fJ Alva, The zone is
Issued Building Permit Receipt 57
Issued
form 523 Bldg. Code