1972, 07-25 Permit App: J3863 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT (9-L31
GENERAL REQUIREMENTS PERMIT FEE f�
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 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
O
Name of�'�wner
Archite/t Phone En
Contrtor Address
Address
gineer
fa/7 i/ 1i✓Phone A;-104'71"
Phone
Phone
Legal Descriptign of, Property (Give. ompl a des ryition from eed, tax receipt, tc.)
.c9 /SYJ 7'
DESCRIPTION OF W K: Newt S AdAlition o1 Remodel
—29
Cine of Loy U c M(.3 —o .VX.2- — �'i'
Const. {/�IY� Dimensions
(Frame, co ete, brick, etc.)
Rooms Baths 2-""-- Basement �I-- Foundation Const
Moving Bl Z nee / Fire Z 3
}Sewage System f/G Stories eri
ati 2-otal/Sq Ft. -.212,i� Valuation L.�09
i rleto etic� Chimney er/C,< Fireplace iris—
(Kind)
GZ"C%G-� Int Wall Finish 147 wy// )
No of Units l Bedrooms S
Private Detatched
(Full, part, none)
Heat. System --2_e _ 're of Roofing `-e'7"j� Ext Finish
Use of Bldg. !//L/Y_ (/
Garage or Carport Attached
ear
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
NORTH
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
ems
SOUTH
I here ertify info oration sub
as shown hs
CL1!Owner or Agent
�"
)A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
State License No:
Ind. Ins. Acct. No.
REQUIRED
///Z ,s.
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
correct and there are no other structures located on this property except
Dd>eCONSTRUCTION COMMENCLS.
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Per t Number
Remarks
S. 9v Dt / `x Reg The zone
Buildinsrmit Receip
1s
V
Form 523 Bldg. Code
/so
F's
4Y
?yam
3y
Id
k� 4- boll
t\I
Ba ee {-re 2. F
'alf/oor 79''
v' /diffcv�f3O"
/0 sk' -is
SP/
a6 ad
7
Iw
.ro'
r /67
`r 6
-f3
J. o OS' /Cok t t
ACill-./SO2.
56'Lai 4 i i.9 1
.',41to?.: £/ /S
3h/yie -' flcres
�zf s 'eedreties,
RECEi V ED-F"r,EA
I FEE CODE CONT ;AV•
•
s'o
JUN 3'0197Z.
MANUAL REFERENCE I I VERIFIED RV
0
et tam. street
1-IEALTH DIST.
JUN 2 3 1972
ENV, HEALTH
F.N.A. APPROVAL ONLY
SPO. CO. HEALTH DIST.
1