1972, 03-21 Permit App: J2252 MHa09( U'
County of Spokane, Washington
�\V • BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE /
FERN IT 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 must conform vlth 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, shouid rSlr 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 st cture abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress.
COUNTY ROADS. Work on stree right -'i ay may not be performed until staked by County Road Department and work must be
performed in accordance wi • stakes 'oints of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. mit required to move an existing building. When a building Is moved on a County or State
Highway, clearanc m .t •j .• ' led from the County Engineer and/or State Highway Department.
ACCESSORY BUILD N'S. • ..1.t y buildings (garages, sheds, etc.) require a separate permit.
-sr
uilders should check provisions of covenants or dedications and easements running with the land
e through civil action. ounty Officials can not bring action to enforce covenants or dedications.
RESTRICTIVE
whici+ a
.i
Nam
Aretfitect
Contractor
egal D script ion o
.S ---
OT or
Owne
CANT FILL 1 BELQ,THIS Ldor
arfr,IWIPMMig!/r
Property (Give
i1
/ /_ ddress
Phone Engineer
omp
Address
eseription from d, tax receipt, c. a e r r
i
Phone
Phone
DESCRIPTION OF WORK: New
)."t(—
F; ice,. 1 //-.ilrensions
Si
C
iFl,: me, concrete, •rick, etc.)o
Rooms Lt Baths 1 Basement Foundation Const • / 11,. i imney Fireplace
" part, none) (Kind) (Number)
of Lot
Addition
Remodel
Moving
Sewage System
Total Sq. Ft.
Bld _i Zone / Fire Zone
Sto s /
valuat50-Cr°
Heat. System
yliP of Roofing //£Ixt Finish Int. Wall Finish
Use of Bldg. - ('cC------n.t41 on C2 ) ,--__ No. of Units Bedrooms a.
Garage or Carport Attached private Detatched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of•exist ing and
proposed buildings; (4) distance to 'erty lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
I he y cert
as shown. . /� A.•a
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
mu Heating Permit
Sewage Permit "
y
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
f i f tion vu itted is correct and there are no other structures located on this property except
a
C1C3--L—C2—
1
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES 'BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
atf, inn O DO • ' WRITE BELOW THIS LINE
Date
Your street address will be (o %,�czen----
Sewage P'father Issued Building Perm
Remarks
The zone
Receipt
1
ssued
. t
2—
Form 523 Bldn Ind.
%k n:1; G V 'r c l t l t 5 H/ /, /1-
/4
'r
f' /://4. #.0 7,9 � ,r .:• /L � r~1' � ✓ . � V
limo -I
j•
a G A.. .57o ,7
8/' 77 �
Lr
1/4/6.2:
P
F 7;
75,0 .- -
1
3
^