1971, 06-02 Permit App: J4757 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
7 •
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE f
PERMIT REflUIRED. 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.
a
SEWAGE TEM. Permits are required in all cases by County Resolutions Nas. 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 e€pt
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
�j -
Name of Owner it °len X 1 .ie a `•' Address __1" ` 3 /d / /�v/`O Phone VA- 9295S• -
Architect �— Phone Engineer Phone
Contractor
Address Phone
Legal Description of Pr�}perty (Give coyygglete description from deed, tax receipt, etc. '
for ,'S/ 1//4, e2 Aiven v/,ij ,44o41F/e /1o`+tc•
Se.�
DESCRIPTION OF WORK: New r
Size of Lot S)h
Const. Dimensions L Z Y 6 Sq Ft Jy uation 3. 000
Addition
Remodel
Moving Bldg. Zone / Fire Zone V
Sewage System S % Stones /
(Frame, concrete, brick, etc.)
Rooms Baths Basement
(Full, part, non )
Heat. System
Use of Bldg.
Foundation Const
ing ism
I,� 'n
��a�—ice°Stt./.. I _ / //./ a /a
Chimney Fireplace t•
(Kind) (Number)
Ext F.ish /11c1" -c- I Int. Wall Finish
No of Units Bedrooms cL...i
Garage or Carport Attached Pric'ite Detitched
/-
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
Arid -er
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
NSewage Permit ` ..
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby er ify informat}'on s fitted is correct and there are no other structures located on this property except
as shown. ! / /
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Remarks
DO NOT WRIO 'LOW THIS LINE
AN;
Sewage Permit Number Issued ����%
_ __ re zone is
Building Permit Your street address will be /1/4.S
Receipt
ssue
Foran 523 Bldg. Code
hS -
eA /''S Sid
LoCiselk 2
—ST/
yIitVi.c /rfu%r/-r %t(o/A
Jv ,,DIVIS
i�6/s G -lams << AZ
//0
c_