1971, 04-28 Permit App: I4191 MH• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT toto
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 mast 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. Where work onwater 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. Where thestructure 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.
A��—PPLICANT FILL IN BELOW THIS LINE My 99°257(
Name of Owner h6 cm^ Address /V ((•i�/6 4/eY% 'Sr -Phone 44, 9 -,?,(5-8
Architect P ne Engineer Phone
Contractor ,-'17p
Address Phone
Legal D-scription of Property (Give complete description from deed, tax receipt etc.)
DESCRIPTION OF WORK: New Addition Remodel
Size of Lot %L C X //a9
Const'rns % fl /'C,f7
(Frame, concrete, bri Lny59u, etc.) -
Moving
Sewage Syste
Total Sq Ft
Bldg.Zone
-,/I�j.�f StoLies
/ " z e1
Fire Zone
Valuat'
Rooms 7 Baths _Basement Foundation Const Chimney Fireplace
9- (Full, part, none) , (Kind) (Number)
Heat. Syste ec-ray c--�Type of Roofing Finish Int. Wall Finish
Use of Bldg. • /—i— a' „(//C Y OS JS'^/ la/ -2l" eD No of Units Bedrooms
Prime Detatched
Garage or Carport Attached
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.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
n. Heating Permit
NSewage Permit
-4
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.
tee_ttly e. ht� 9- s 8'7/
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
�//1 l ��/ X�
Your street address will be XJ p�// / JQ,�� - The zone is fie AinL )(y��
Sewage Permit Number Issued Building Perm, Receipt ?Issued
Remarks
Form 523 Bldg. Code