1971, 10-05 Permit App: J0872 Residenceri
B 0
County of Spokane. Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE. WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT`
ee
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
Name of Owner a Address LO f '< s cA/< Phone / it g37Y
Architect Phone Pngineer Phone
Contractor %M a Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
— =d Sty 075-yy--/flI j171 -a/ a4K2
Ufa[p%_d/ tag:a
DESCRIPTION OF WORK: New ir Addition Remodel
Size of Lot /AY k /PT
Const.Fi?eAj t. Dimensions SPX 9!f 4-Q 8e5t.ctyl 1/9.1)
(Frame, concrete, brick, etc.) ,�p
Rooms 4 -- Baths S Basement evx a Foundation Const Ce wen h_
Moving Bldg. Zone/ / Fire Zone 3
Sewage System Stories Vac
Total Sq Ft. /'/77 Valuation /fin
(Full, part, none) /%
Heat. System E -B% Type of Roofing t.�kh• Ext. Finish
Use of Bldg. reps . ji.ye i u
Garage or Carport Attached 444 -
law sketch with dimensions showing: (1)
Proposed buildings; (4) distance to property
tem and water supply lines.
r/-//
Chimney
Fireplace o2
(Kind) (Number)
Int. Wall Finish ORy e(4
No. of Units / Bedrooms/_a_
2 Resit/jet
Private Detatched
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys
SOUTH
I hereby. rtify . tion submit ed
as shown.
is correct
and there are
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit der 125,1
Sewage Permit %4c., •
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
no other structures located on this property except
Owner / 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 LINE
Tour street address will be
Sewage Permit Number
Remarks
Issued
Building Permit
e zone is /:% £.r Z rRee11.
2 -Receipt 7/00 Iss/ued
Form 523 Bldg. Code