1972, 06-07 Permit App: J3316 MHs
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT/ a o
GENERAL REQUIREMENTS PERMIT FEE 36
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.
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.
,F]-{ -} APPLICANT FILL IN BELOW THIS LINE
Name of Owner Rci /_*&tZ' j,'itf-&!.thfl/ Address/
Architect
Contractor
Legal Description of Property
OT /2 Phi(.1
.r�d, 9ntrJf er 99.0-27
7/.S Ad, _LA
Phone WA -4 - /474
Phone Engineer Phone
Address hgge
e„p
(Givomple descryption f om deed, x r cefat, etc.) 3 D$552 -i0dit.�
aLf�J( �l/'lilJikJ .�Y B-vtti(.a _
DESCRIPTION OF WORK: New
S,c`�eoofuLot • 6 d /7
Cama--' imensions .24 y d U
(Frame, concrete, brick, etc.)
Baths Basemen f f_ Foundation Const t� 7i JOCK Chimney
(Full, part, none) ---yy--
_Type of Roofing.(./ii.
I/ Addition
Remodel Moving 131dv Zone Fire Zone S
Sewage System • _ u Stories-�_
Total Sq Ft O Valuation i36ao
Rooms
Heat. Syste
Use of Bldg.
A-na, OA 4CdtiM lr
Ext Finish
Fireplace
(Kind) nn (Nu ber)
Int. Wall Finish <(.10.-
No of Units Bedrooms
Garage or Carport Attached Private Deuached
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.
En
En
N
76
NORTH
o1(tita ch
Pia
MAR I.E77A
•
I here_, certify infor
as shown
SOUTH
State Lscense No.
1 / AAM/LN-
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
in Heating Permit
Sewage Permit
ti
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
on submitted is correct and there are no other structures located on this property except
7 -72
-ner or Agent
` A LAND USE 0 STRUCTURE'PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
y
DO NOT WRITE BELOW THIS LINE
Date
CONSTRUCTION COMMENCES.
Your street address will be / R 7 /S `, v(�/Q „t ._ The zone is 16,4__A, ,Q
Sewage Per it Number Issued( Receipt Issued Building mit /
Remarks o-,�-Q-�_— 3 /
Form 523 Bldg. Code
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