1975, 12-10 Permit App: L2295 Residence1
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 ovwater 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.
SETBACK 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 SP Qy'ap7
Name of Owner aAddress 20 aw %oCILPhone 8'3�-Zai
Architect •Address
Engineer r Address Phone
Contractor 9 9 n e Address Phone
Legal Degcript Property Give complete desGrjption from deed. tax receipt c 1
Ayt 0 /0c it _?8 Aly real c PS
t7r, O1t
PAtem/ i°' iti7.14'2- `9'662
DESCRIPTION OF WORK: New ✓/`Addition
Size of Lot lam X I yL
Remodel Moving
Sewage System
Stories Dimensi s ,2 X J(
RoomsBaths AsFull. part nnonrT—�/
Heat. System S Type of Roofing
Use of Bldg. . (;Jenee
Bides Zone —Fire zyprd 3
g anal. f
Fr., Conc.. ry etc.)
. Id, Valuation / I OOA.OQ
imney Fireplace e2
(Kind) yyrr (Number
Int Wall Finish `/%y/✓R3 //
No of Units_ Bedrooms J
.od Total Sq Ft
Foundation/Const. 4.n G nit Ch
)t d we S nE _I_Ki-nish 004
ice/'/.f./i/{I �IAAILe tea
PLOT PLAN
Dram 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 bufldings; (6) location of sewage sys
tem and water supply lines.
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NORTH
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223 -IR !7904/
Ind. Ins. Acct. No.
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REQUIRED
Pr/Se iii
Plumbing Permit
Heating Permit
Sewage Permit
v TSA
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
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Owner or Agent 37
/Q bac
Date
'TA LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THI5 15 NOT A PERMIT.
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Your street address will be // 9G-0 s e, nava �,_, _, The zone ie$Cl/�'i,c/.1-[ fnM*
Sewage Permit Number Issued Building Permit �••ya,9s Receipt /6/1 Issued
Remarks
DO NOT WRITE BELOW THIS LINE
464.
Form 523 Bldg. Code
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