1971, 09-08 Permit App: J0612 Residence• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT i •
GENERAL REQUIREMENTS PERMIT FEE .2
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 47235.
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 OP 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 j,//iaJ"J4ns y (�av2i'j
Address 1 Z. t 2 l fr i /.t/ Phone 4/4q- c/(670Architect 1/�f7wta•-L. JJ ,�� 'Phone Fngineei Phone
.
Contractor tt,/ .��. r-i.k. Address Phone
Legal Description of Pro. rty (Give complete description from deed, tax recei.t etc.)
DESCRIPTION OF
WORK: New Addition
Size of Lot fir > '< i Z 5"
Const F/t[LV+u. Dimensions -/ 2' X `. &?
Remodel
(Frame, concrete, brick, etc.) r //
Rooms 7 Baths ) Basement Foundation Const
(Full, part, none) ,O
Heat. System rtA - Type of Roofing &-z-2-17X-
Use of Bldg. /(rF 2 : 7
Garage or Carport Attached
Moving Bldg. Zone / Fire Zone s3
Sewage System q -P iJ�(w%G Stories i
Total Sq Ft. 1 1 7L Valuation 1 S� 000
£jY.0 . Chimney Fireplace %cen—C-
.t (Kind) 9 (Number)/
Ext Finish /// de' d Int. Wall Finish -1. ea -.'i,1`
No. of Units $ Bedrooms 3
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.
NORT
H-7
SOUTH
I hereby certify information submitted is correct and there are
as sh..
-41 t.
rn
N
y
no other
State License No.
22-3 0I e1790
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit .i*^0 7-
Heating Permit 4
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address w111 be
Sewage Permit Number Issued
Remarks
Building Perm
1 e zone lis
�ZReceipt to/
Form 523 Bldg. Code