1972, 06-06 Permit App: J3258 ResidenceCounty of Spokane. Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT / �� 700
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 must 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-BAra 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.
ST4TE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
an egress. A
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 au existing building. When a building is moved on a County o/' 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
Phone
ddress
engineer 0,1,s Phone
Address �J�J Phone
Phone IQ - 7j 7
Legal Description of Property (Give complete description from deed,
-O./
DESCRIPTION OF WORK: New L. ----Addition
Size of Lot '7 x l 0 d
Const. r _-Y - Dimensions i' %/ U — a a y- a
(Frame, concrete, brick, etc.)
Rooms Baths / Basement fo/ // Foundation Const
(Full, part, none)
Remodel
Moving
Sewage System
Total Sq. Ft
Heat. System
Use of Bldg.
Garage or Carport Attached
Bldg. Zone
Fire Zone
Stories
Valuation Ss,a. 0 0 0
Chimney Fireplace /
(Kind) (Number)
Type of Roofing d Exi. Finish vow . _ . Int. Wall Finish
J21 L- —g.e �oNo. of Units BedxYooms '0 _
Private Det.Itched
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.
NORTH
State License No.
?-
3 --
Ind.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
�n Heating Permit
N Sewage Permit
Plans Received
Plans Checked _
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
c v�
Owner
Agent
G --6-7a
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
74,ali / DO NOT WRITE BELO THIS LINE'
Your street address will be 1f0 ,c The zone is
Sewage Permit Number Issued
Remarks
Building Permit
Receipt
Issued __Ap___
Form 523 Bldg. Code
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PAL:, 1? SPOKANb; COUNTY, WASHINGTON, -.1LCN'T THR
NORTH 100 FT TIBREOF AS MEASURED PEIPSNDICULAR
TO TEL SOUTH Lfl; 16TH AVXUL,
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JOSEPH L DiCKINSON
PROFESSIONAL FANO SORVEYOR
Spokane, Wath, R9206