1972, 02-22 Permit App: J1940 Residence1
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
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.
NATER. Water supply must be approved by the County and State Health Departments. Where 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. 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
Name of Owner1. G• e /= -11-1 .1) 67 phone /H/J)
Architect Phone
ddress
Phone Engineer
Contractor AddressPhone
Legal Desc iption of Property (Give complete description from deed, tax receipt, etc.) a!�f .0(`4, 11 9/
/2331-4/6-3
DESCRIPTION OF WORK: New L ------Addition Remodel
Size of Lot /, s > X 14 6lL/ P/Wo
Const. - - Dimensions 4Y0 X -2- 4'
Moving Bldg. Zone / Fire Zone 3
Sewage System --re T i r Stories
(Frame, concrete, brick, etc.)
Rooms ,% Baths / Basement
(Full, part, Lione) p
Heat. System/774. C4 S Type/of Roofing e -:t rA t
Use of Bldg.
Garage or Carport Attached
Total Sq. Ft. 9 7 3 Valuation J 9/ L' c/
Foundation Const.
t '
ChimneyJre ( Fireplace "7 -1 -4, ---
(Kind) j (Number)
Int.Int. Wall Finish Q
Ext Finish%L ✓�-�
No. of Units
Private Detatched
Bedrooms <3
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
SOUTH
I hereby certify information submitted is
as shown. -
correct
ne or
tG 6 y;
Agent(/ Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
State License No.
3— /'62s_5
Ind. Ins. Acct. No.
91-e5 9.1'
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
and there are no other structures located on this property except
(m, nraa„ DO NOT WRITE BELOW THIS LINE
Your street address will be
A/.
Sewage Permit Number Issued Building Permits 7 9 -),
Remarks
The zone is
Receipt 6.7 y
4..tr4is. . i.
Issued
Form 523 Bldg. Code
PART LF :.;v:,; OF i,;E-4 �� ;. �:', T.25N. , R.43 .W.M.
SCALD: 1" = 50' DAT: Fb. 16, 1972
This will certify that a field survey was performed under my supervision on
the following described rrcpPrty and the nropQrty corners were set as shown.
DESCRIPTION: Beginning; at the northRast corner of Tract 174, Orchard Avenue
Addition, Spokane County, `,4ashington; thence WFst, a distance of 11.0
feet; thence South, a distance of 25.00 feet; thence 'ir`est, a distance
of 40.00 feet; thence South, a distance of 75.00 feet; thence East,
a distance of 15.00 feet; thence South, a distance of 25.00 feet;
thence East, a distance of 3'.:')0 feet to a point on the east line
of Tract 174; thence h:orth, a distance of 125.00 to the point of
beginning and the north 125.A fret of Tract 175, ur•chard Avenue
Addition, Spokane Comity, Wa: Kington.
1, ;JUN5MOR4
Mt0ii:,,J1uN4+L LAND :31JR/ r(0R
N. 1203 HiltaLD Kula
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