1972, 11-29 Permit App: K194 Residence•
County of Spokane. Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS
PERMIT FEE..
PERMIT REQUIRED.
liuse ostscyucResolution
erect
building
structure
the
kind
or alter any buldingorstrucurealreadyereted, ortohangealanduse. Constructionmust conform with
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 ROM PRPERTY LNES. In mostk from
least 25'Fis required, al 5' side yard,Z15' side yardrfromtacflankingnstreet, sand bac25' rearhyard e oare nt property line, of at
required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must egress.
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.
RESTRICTIVEicCOVENANTS.eblBuilders uaction. Countysions Officialsf ocansnts or not bringdactionns tosnd enforcements covenantsing with the land
r dedicatioks.
which are enforceable through civil
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
Arrpitect
Contractor
1/1/, , , f ? PILES' Address
$ %}/77 e Phone Engineer
e Address
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
/Or 91)( '1 GA s7 e- A-
d
egt
DESCRIPTION OF WORK: New X Addition Remodel
Size of Lot a -x 3 �)
Const Pry} a Dimensions r720,0-4/117 Xg--.3-+/8 X04.
(Frame, concrete, brick, etc.)
Rooms A6' Baths Z Basement F)LL Foundation Const
(Full, part, none)
F /4' L Type of Roofing _SA si rP
Heat. System
Use of Bldg.
S/ X11 P FA rl
Garage or Carport Attached t9 A I
•
Phone
Phone
Phone
9a /'07
Moving Bldg. Zone Fire Zone
Sewage System 5 ) 2 R Stories
Total Sq. Ft. _____Valuation ZA UU
G a .r.t C_ ChimneyM Fireplace
(Kind) 1 (Number)
Int. Wall Finish S -h r
No. of Units __.L— Bedrooms
Ext. Finish / // /
A- 7T
Private Detatched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings
temd water supply lines. --
NORTH
ATT
m
•(3) (6)1ocation ocationoofexisting
sys-
r State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
441
Sewage Permit
Plans Received
Plans Checked _
Plans Returned.
Plans Picked Up
Plans Mailed _
SOUTH
I hereby certify information submitted is correct and there are no other structures
as shown. .
i
�/-2
located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
BELOW THIS LINE
Your street address will be_
Sewage Permit Number Issued
Remarks
Form 523 !Aldo_ Code
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St k >k-4
C "1St ft A DD
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