1971, 04-30 Permit App: I4200 Residence0 0
County of Spokane. Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, 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. Where work on Water connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Offices-•-_�,
SEWAGE SYSTEC===P&rmits 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,,rclearance 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 ai%,enforceable through civil action.. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner rra^�� rl CAL�.44 Address %�Tt?� j/f�i�/V !��i �yL� Phone &(a, 4(3 a8
Architects Phone Engineer Phone
Contractor CO, Address Xi 2204 a,;P,r?1V-A I✓,E Phone A,/;,44.328
.Legal Description of Property (Give complete description from deed, tax receipt, etc.)
/ 5413
DESCRIPTION OF WORK: New. Addition Remodel, Moving Bldg. Zone Fire Zone
—
Size of Lot /O/)' )( /-v) Sewage System ��PT<G 74_&K Stories .I—
Const. mlg Dimensions 4110"X 1610"' t `LG �O" < 16'-0" &I % MA&E" Total Sq. Ft. O(o Valuation 24 4�
(Fra e, concrete, brick, etc.)
Rooms. Baths _L—Basement. Foundation Const. ��� SL1TE Chimney Fireplace /
(Full, part, one) , (Kind) (Number)
\Heat. System WrA - LEAS Type of Roofing QA4PO Ext. Finish (660ri Int. Wall Finishhx'� MSL
�.
9,.:an'd
No. of Units �_ Bedrooms� yPLOT PLAN sketch with dimensions showing: (1) property lines; (2)street or road locations; (3) location of existing and
d buildings; (4) distance to property lines and streets; (5) dimensions ofbuildings;(6) location of sewage sys-
water supply lines.
NORTH
SOUTH
State License No.
L94,29'
Ind. Ins. Acct. No.
j/ 5,k
- REQUIRED
Plumbing Permit
m Heating Permit A•
N
Sewage Permit c-16NN /NGH
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ify inf-eta nnjsubmitrted is correct and there are no other structures bated on this property except
Owner or Agent/ / Date 6/
A AND 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
�� (J
C
e/l :a
e zone is - 4#3
Sewage Permit Number
Sewage
Issued
Building Permitj�l.
Receipt - 'Issued
Remarks
Form 523 Bldg. Code
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