1972, 02-16 Permit App: J1885 Residence0
County of Spokane. Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE. WASHINGTON 99301
APPLICATION FOR LAND USE OR STRUCTURE PERMIT —) a
GENERAL REQUIREMENTS PERMIT FEE)O
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 t0 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. There 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
Name of -Owner
Architect
Contractor tAked
Legal Description of Pro erty
sr AI A
/ OSA(
r.. ddress 10 1-1 2 7 F. 1 3 Phone 14/4 "&9I S"
,o�, Ph:.e Eng sneer Phone,
L-��✓+- . Address cl 2- 0 41 E ,,,(- Phone 6t/ 4 1.{ -4-412.19
(Give complete description from deed, tax receipt, etc.)
DESCRIPTION OF WORK: New Addition
77
Size of Lot o v x 1 7
Const. Fvury,, 0 Dimensions L( 0 X 2. t/
(Frame, concrete, brick, etc.) ���� y
Rooms 4.".,�—___ Baths 1 Basement Foundation Const t._-nte .
(Full, part, none) ,O
Heat. System Cra4- Type of Roofing J n -7s.1-- Ext. Finish
Remodel
�_ /
Moving Bldg. Zone / Fire Zone T3
Sewage System ✓.� 27.2 Stories 1 '71 -
Total Sq. Ft. Valuation I g2 0 d 0
/ 0Chimney Fireplace
(Kind) (Number)
Int. Wall Finish.-u-olt
No. of Units 1 Bedrooms 2..
Use of Bldg. ,CLI.
or Carport Attached
PLOT PLAN
raw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
posed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
Private Uetatched
-I
NORTH
as sh
SOUTH
E. N�
I hereby certify information submitted is correct and there
State License No.
X2.3 -OI -67710
Ind. Ins. Acct. No.
REQUIRE
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
are no other structures located on this property except
Owner or Agent
1
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT_ RITE BELOW THIS LINE
Your street address will be 13
Sewage Permit Number
Remarks
Form 523 Bldg. Code