1972, 03-02 Permit App: J2062 Residence• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 4/
GENERAL REQUIREMENTS PERMIT FEE /--
PSRMIT 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.
SERfGE 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 Address /,26 0 1/
Architect Phone Engineer
Contractor ._P'c -,-r- - Address
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
/-441 /(7'SZI. /P 7,-->-....' G -1,f
Phone:W '- S TDD
Phone
Phone
fi t 37-_ <6a 1
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone / Fire Zone ._
Size of Lot G4i• S X /4" Sewage System - Stories /
Const„. Dimensions -41'D ' x c52 -LZ 4 Total Sq. Ft 5 ` 7 Valuation /a44 -
(Frame, concrete, brick, etc.)
Rooms Baths —1 Basement Foundation Const. &e� Chimney /.� Fireplace
(Full, part one) (Kind) (Number)
Heat. System l N R12, Type of Roofing de ---bis Ext Finish Ma -z Int. Wall Finish p.t1..,e uifn�2
Use of Bldg. (ten/ �'�/_� .�,e�j��-e,a��...r-C% No. of Units / Bedrooms .3
Garage or Carport Atta ed 72` Private Detatched
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.
m
VI
NORTH 1= /VI AR/EfiA
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certi y informatio .ubmited is correct and there are no other structures located on this property except
as shown.
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
6:zu DIA 0,E
Tour street address will be 760 fa,
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW THIS LINE
BufIding Perm
The zone is
Receipt 213/-1 Issued
Form 523 Bldg. Code
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JOSEPH L. DICKINSON
PROFESSIONAL LAND SURVEYOR
F. 9616 MONTGOMERY