1972, 09-28 Permit App: J4584 Residence, Renewal of J0455}
110
- County. ®f -Spokane; lWashingtOln - -
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 most conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. 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 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
are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL 11.1 BELOW THIS LINE
Name of Owner
AFthabcEf.
Contractor /
Le gall Des ip onG
ddress
g ineer
Address
Phone
Phone
Phone%{/Q' 3 ad
t ion
tion from deed, receipt,
DESCRIPTION OF WORK: Ne iy Addition Remodel Moving
Size of Lot /,-0 x /
Const Dimensions 9—r)( (76 / 3 X a/}' . Total Sq. Ft.
Foundation Cons✓ i Chimney (Kind)
Ext. Finish Int Wall Finish
Bldg. /• ne —.-- Fire Zone .3
Sewage System
(Frame, concrete, brick, etc.)
Rooms Baths co Basement
(Full, part, one)
Heat. Systen C _ Type of Roofin
Use of Bldg.
c or C
ories
Valuation
PLOT PLAN
Draw sketch with dimensioshowing: (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.
Fireplace
(Nu(ber)
No. of Units __ Bedrooms
Private Deta t ehed
-I
theig
NORTH
6)(tycp,„4 /Lk
I hereby,certify
as shorn. -
REQUIRED
Plumbing Permit
rw Heating Permit
Sewage Permit
ra
N
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
on suitted is correct and there are no other structures located on this •perty except
ner ot�aynt, Date
A LAND USE 0 STRUCTimr PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will hu
Sewage Permit Number
Remarks
Form 523 Bldg. Code
DO NOT WRITEBELOW1HIS LI
U 33 i 0 � -. Q1if,��,e Orme is
yf. tf Receipt.
Issued
Building Peril