1976, 04-28 Permit App: L3569 Residence•
Canty of Spokane, Was!gton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 6C
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 cbange a land use. Construction must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
RATER. Rater supply must be approved by the County and State Health Departments. Where work on water connections disturbs
the pypppsurface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SER E SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47235.
SET CR FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
lea 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 an 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.
ROVING OF BUILDINGS. A permit is required to move an existing building. When a building Is moved on a Couny or State
Highway, clearance must be obtained from the County Engineer and/or State Highways 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 4 2 a- / c
Address A - Sr, -, a u Phone %2Y—'7/G
Name of Ovmer
Architect Address Phone
Engineer Address Phone
Contractor !/ Q Address
Legal s Tonna ofGrope -171 ne complete des 4�tleetl. t p •44
-
Phone
ax race' t etc
DESCRIPTION OF WORK: New .1 Adddition�j Remodel Moving Bldg on�j 7_ Fire Zona T
Size of Lot JS/ X y'Q ,f�+.�/A +c✓ .ti Sewage System 66� Const
9-1— ,r (Fr., C Br.. etc.)
Stories Pinions' no 3 r Total Sq F Valuedn 6-10000Rgisna s Basament Fou tion Cwrst Chimney plac
���/ddl`"_��I FFF��I pe (K(Rind)e INumb
eat. ys em Type of Roofing = ia��� Ezt Finish Int Wall Fini
Use of Bldg. No of Units _ B rooms
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
/R BE IDENTIAL—COL- ERCIAL
•
as s�I hereby cert fy Information submitted is. correct and there are no other structures located on this property except
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SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
as Heating Permit
Se
Sewage Permit
ti
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
-t 4 ria D
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
A
VAt -nucleya DO NOT WRITE BELOW THIS LINE
7 Tour street address will be 2 0 £:1 2. -51,714 -.The zone
Sewage Permit Number Issued Building Permit Receipot
Remarks
form 523 Bldg. Code
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