1976, 03-08 Permit App: L2878 Residence•
Colby of Spok'ane, Washiron
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON
99201
APPLICATION FOR LAND USE OR STRUCTURE PERMI1
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
Spkane County Building Code and Zoning Ordinance. Construction is subject to inspection.
W. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs ee surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
WAGE 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. 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
LJ 6
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Name of Owner 44. . S" 91- 4 .f 1' O C' Address .Se' -' 2 6 /" /AV'rf Phone 9'L- t 3,7e-19
Architect Address Phone
Engineer Address Phone
Contractor S A41 L Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc )
L /Ji PC C ,s m fit oz./ t5179 !/'.f
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DESCRIPTION OF WORK: New Addition
Size of Lot J 01 A 2 89 !/Z ate -6)
Stories Dimensions O'fS&- .33 r
Rooms 7 Baths Z-' Basement CAI L L
(Full, part, none)
Heat. System P/! . EL LA Type of Roofing S'".0//N/CL
Use of Bldg. f2 es -%CI �.,�,(fC . 0'11
Remodel
Moving Bldg. Zone ! Fire Zone
Sewage System t '/7 4- Const. F.44141 t
(Fr., Conc., Br., etc.)
Total Sq. Ft 232 Z Valuation 6 a/
Chimneyireplace 2
(Kind) (Number
Ext. Finish /'=/109/114. Int. Wall Finish p1e/19L-(
No. of Units _ Bedrooms
Foundation Const.. G nig/ G
Li 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.
NORTH
........1„..,_ e,--,--- —ez— €
_, •{---e e
SOUTH
I hereby certify information submitted is correct and
as shown.
m
there are no other
State License No.
Ind. Ins. Acct. No.
// — /7
7"
REQUIRED
Plumbing Permit -Mgt dalO
Heating Permit a N< S r i r7/ -
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
0-A, 7/1/L,a2 DO NOT WRITE BELOW THIS LINE
Your street address will be //Q/Z---
The zone is
Sewage Permit Number Issued Building Permit, o� n /I Receipt(4j ;Issued
Remarks
Y47
Date
CONSTRUCTION COMMENCES.
Form 523 Bldg. Code
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PLOT CLAN
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