1971, 06-21 Permit App: I4847 MHCounty 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. 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 q 9.2-4
Phone (Nle /I/ A
-
Phone
Phone
Name of Owner -7Y Address
Phone Engineer
Address
Architect
Contractor
Legal Description of !KM (Give
gtj
.� id.4ie./.. 4L i. 3
let desc iptioR fr m deed, tax receipt, etc.)
DESCRIPTION OF WORK: New %/ Addition Re odel
Size of o d 4 —
Const ' t, Dimensions X 3i
(Frame, co trete, brick, etc.)
Rooms 3 Baths 1_ Basement
(Full, part, none)
.4 • Type of Roolin
Heat. System
Moving Bld Zone /
Sewage System ,P .Gfi
Total Sq. Ft. ��L Valuation
Foundation Const
Jio
Use of Bldg. %,_1.,-).1-(1.1 Q.d ./X -6d-4. .r.4 -PJ.
Garage or Carport Attached
Fire Zone
Stories
.4)D'
6.6-4- Chimney — Fireplace
(Kind) ���ber)
-7141/1-41
Ext Finish Int. Wall Finish
No. of Units Bedrooms
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.
NORTH
C 21T44uA'.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
en Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify infor on submitted ,i correct and there are no other structures located on this property except
as shown, n �y� � i��K � e-leP ,
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS UNE
Your street address will be
Sewage Permit Number Issued
Remarks
e zone iO4.11.'
uilding Perini Receipt 54 (( Issued
ii(t) 6/7
Form 523 Bldg. Code
‘-- Da- S, )4444." Cia0-11 •
751)
Halei÷ 6/449 /71/426
WEST VALLEY EXCAVATING
S. 812 DISHMAN ROAD
WA.4-5130