1971, 10-04 Permit App: J0883 AdditionMoir
County of Spokane. Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201 Cn
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 mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. pater 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 OP 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 Owner //2ae=' 22:I -C' Address
Phone
Architect„22 - Phone Engineer Phone
Contractor .../C4....4.-4,6 . / . - Address / Phone
a
Legal Description of Propert ( ve complete descriptio fro deed, tax receipt„ etc”) e 4 o '
Lei' /5— _ le .-<-:-.-_ 4—trot 2.2-4-4-e,--. cr.-4
/_4/__5-S-7 . 6'0 7
DESCRIPTION OF WORK: New Addition X Remodel Moving Bldg. Zone
S' �
Size of Lot it/2- Sewage System g�'�
Const 7-----1-...0-w-....‹. Dimensions / li Xi' Total Sq. Ft. /l/ Valua
(Frame, concrete, brick, etc.)
Rooms Baths Basement Foundation Const. (17 --e
(Full, part, none) Chimney Fireplace
(Kind) (� (Number)
Heat. System Type of ' oofing �. Ext. Finish / --/- 7/ Int Wall Finish
Use of Bldg. `"'�r-r cu-ae% � ' - -r-Cty
Fire Zone
Stori s
St / if9n
Garage or Carport Attached
No. of Units
Private Detatched
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.
m
H
NORTH e� 0.L ..„67
SOUTH
State License No.
23_oi -6go7'
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify inon submitted is c< tett and there are no other structures located on this property except
as shown.
ner
or Age
/°/r
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
Your street address will be �'� 2 4L�-r�.i�-�r�C-,��. a zone Ss --
Sewage permit Number Issued Building PermitReceipt slued _
Remarks
Form 523 Bldg. Code