1972, 04-19 Permit App: J2690 MHi
County of Spokanegl Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT Al
GENERAL REQUIREMENTSPERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required byCounty Resolution to erect a building or structure of eny
kind or alter any building or structure already erected, or to change a land use. Construction most 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 41.235.
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.
a r -r // APPLICANT FILL 1H BELOW THIS
�LII1E9Jp p J- qq (4.
Name of Owner .M�-l�-1, ti/'C Ill•-Oi Address Y/ c3/UA�J ./gad Phone Yl/A -'ti"aQJd
Phone
Qa
Architect
Contractor
Legal Description of Property
ILUT 3 J3C/(
Phone Engineer
Address
Phone
3 ,deed, az receipt etc )
& 7s -s/ - oses
./
( ve complete description I'G�C.C,de
f om
A41-64--M-1-1,t41-1
DESCRIPTION OF WORK: New Addition
S of Lot .1 ae� �0f �X� /DO'
ons `t illi ^"Dimensions /OA'30"
(Frame, concrete, brick, etc.)
Ftoms Baths / Basement " Foundation
•/ (Full, part, none)
Heat. System D �� ,, P4 Type of Roofing
Use of Bldg. �r"tuitt-/-' d i
g C4
Remodel Moving Bldg./Zone��—L--- Fire Zone
Sewage System_ /2 .p.IAX Stories / O c.,
��-.TT,otallSSq. F� t.. C 00 Valuation loot)
Const �T /,CC4L l_ i.Z -e.10 Chimney Fireplace
(Kind) far)
C Ex[ F Wish -71i/J-41-itInt. Wall Finish
4,/ No. of Units _ Bedrooms
40,44-0-0411, nc-e4
Garage or Carport Attached
Private Detatched
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.
/RA
eceA C.E 17NORI?/VA /Da
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10f
v0PaSfD .N0/3.14
.4014
i
6_
SOUTH
m
ti
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit \�
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
property except
p^.,/� erp' y o ma are no other structures located on this
as shown.
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOTA PERMIT.
(� 2rt.'et) DO
NOT WRITE BELOW THIS LINE
Your street address will be /8t' 0
I he eb c of i for t' n submitted
r v'
Owner or Agent
is correct and there
e zone 1
i
414
Sewage Permit Number
Issued
Building
Perm
.Receipt
Issued
Remarks
Form 523 Bldg. Code