1972, 01-04 Permit App: J1606 Residence® 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 mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Rater 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 kigineer,'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 car. not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
/ o // a 5-
o.�
:
Name of OwnerS.--- -r s+x �y%7 Address
Architect -�, Phone Engineer
Contractor Address
Legal De cri tion of Property (Give complete description from deed, tax receipt, etc.)
a
Phonek-e- S 8 "2— 3 /
Phone
Phone
5—'1/ — 0341(...
DESCRIPTION OF WORK: New X Addition Remodel Moving Bid . Zone— / Fire Zone 3
Size of Lot - l i a [r Sewage System'�""` Stories
Co:..,,•Dimensions 2G X 3 C le SX /2 4% Total Sq Ft. /-5--/ �-- Valuation 2/ so 0 G
oncrete, brick, etc.) �--
Rooms Baths 2 ment Foundation Const z"o ' Chimney Fireplace
/y//]]](���n ///��� ull/part, none) `, / (Kind) (Number)
Heat. System--� Type of Roofing Ext Finish / / // Int. Wall Finish
Use of Bldg. .0-0--e-A- No. of Units Bedrooms 3
Garage or Carport Attached
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location ofrexisting and
proposed buildings; (4) distance to property lines and streets: (5) dimensions of buildings; (6) location of -sewage sys-
/ 1)em and water supply' lines.
PLOT PLAN
Private Detatched
NORTH 9.0
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit —2--a.
in Heating Permit
Sewage Permit
.n
ti
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 located on this property except
as shown. (� ,L�- - 7�
O Owner orrAgent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
/}bIntj44 DO NOT WRITE BELOW THIS LINE
Your street address w111 be' // 7 D Q. C2 77 4 f
,Sewage Permit Number' Issued Building Perm.
Remarks
e zone 115 -2-41
Receipt yy-q=- -sued
Form 523 Bldg. Code