1971, 04-22 Permit App: I4130 MH9
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99207
APPLICATION FOR LAND USE OR STRUCTURE PERMIT r,
GENERAL REQUIREMENTS PERMIT FEE ( l"
•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.
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 cas y-c'unty 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•Hlghway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc,) require a separate permit.
RESTRICTIVE COVENANTS. Builders should chock prcvieiene of covenants or dedications and 0040m0nte !MOlinn with tho land
which are onforeoable through civil action. County Officials can not bring aetien to oafereo assonants e! datlieatisns.
APPLICANT FILL IN BELOW THIS LINE
Name ate 6wn8r
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Contractor ¶i csocen Le
Legal Description or Property (O
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DESCRIPTION�OFF WORK; New dd4lon Remodel moving Bldg. Zo e � Fire zone
Sine ot. L / ime 1 1 'n ' Sewage fit
l Stnries
Const. Dimensions 1 Z� � t) ( Total Sq Ft % Valuation M- ‘The
(Frain?). nerete, Meg, etc.) �l 1 A f
Rooms Baths � Basement _CD_ Foundation AConst kerne.-'1 Chimney I �'Q Fireplace Nra
,^, t1��1�, (Fulh part, none) h (Kind) (Number)
Heat, System ,J2J 3en- • TypeJ�of _R�oofing m' Ext, Finishf�� In -C1 -IC/ Int Wall Finish _T Q
Use of Bldg. Y,`r4-:-Qt T'iamt-e ( -A Q %u- tA No of Units ( Bedrooms _2
Cartage or Carport Attached )J a
Pnvnte Dotntehed
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 ses-
t•' and water supply lines.
NORTH
SOUTH
s/correct an
State License No,
)
Ind. Ina. Acct. Ne`
REQUIRED
Plumbing Permit
Heating Permit
NSewage Permit
N
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
there are no other structures ocated on this property except
Owner or Agent ,ate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS HOT A PERMIT.
Your street address will be
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW THIS LINE
Bu ,gP -'�Q.� 42%i
Building Permit '' I' Jm Receipt Issued
e zone is
v
Form 523 Bldg. Code.
Th 5S CteAvrni
Lf 13/cci3 (iftai Comeer74-.)
SCALE /