1972, 07-25 Permit App: J3862 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT �/�ftv
,GENERAL REQUIREMENTS PERMIT FEE -7C'
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
Name of Owner .' / an' 4' ddress dr O C i/._ S- Phone /3 f -%L4 -4 --
Arch itect
Architect S..-_ Phone Engineer Phone
Contractor Address Phone
Legal Description of PYopeyty (fqe complekaOC iptlDn from dee tax receipt, etq.)
&�-,5-5"7/— / Agy V/ al......, GY'G.'
DESCRIPTION rQ=� VIRE: New Addition Remodel Moving g. Zon _/ Fire Zo
Size of Loy t9 •J / Sewage System/ y�,,///l' Stories
Const tY>r'— Dimensions,9' // 4 'X /�r.--15"1-171-Total Sq Ft t/!7'. /1 Valuation
(Frame, concrete, brick, etc.) S74/Fireplace — - -
Rooms Baths 1 Basement/ `//r Foundation Const/' -7^v '/ Chimney �'�/G/ireplace
(Full, part, none) �j (Rind) (Number),
Heat. System —2—/ Type of Roofing Ext Finish 00 -e -CC , Int. Wall Finish
Use of Bldg. /No of Units / J
Bed
Garage or Carport Attached
Private Detalched
�L-
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 fy information sbmltted co
as shown.
f,. _ //
State License No.
Ind. Ina. Acct. No.
REQUIREDU
Plumbing Permit' 1t
Heating Perrot
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
t and there are no other structures
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
\THIS 1S NOT A PERMIT.
ll DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Perm Number Numbers -7__— Issued
Remarks r
0Qf/7
located on this property except
CONSTRU
Building
The zone is
Receipt
TION COMMENCES.
'\in 523 Bldg. Cod: