1972, 06-16 Permit App: J3411 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT 3Z
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
Spokj-ne 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. i
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. r
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 - iR CA 1 K c, ..I D 14 /,).3 roAj Address 1 2 (9 O'-�� p4 L Phone !72- -5-?o O
Architect Phone Engineer Phone
Contractor Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) PAMCE 1- # IS75-4/11- 67,9 4/
LoT �� Ceo
64.L< 2 , A I- pg �s Su r1 P"D i .J t S / v
-�/�40 SSD TGrst e_-_L,.flw. T �j c Gy�,
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone ___ ,L_ Fire Zone
Size of Lot 195 � 1! l 'y 1 • G 8 � Sewage System _ 54;Q71 L Stories 1 !/Z
Const. F2atvM IS Dimensions 39 ik 2.5 -F ;o i3 'y 2.N Total Sq. Ft. 0,5P Valuation 1% cw G
(Frame, concrete, brick, etc.)
Rooms Baths --- ]— Basement FtAL L Foundation Const. �ovie�2er� Chimney Ift=p4L Fireplace d_
(Full, part, none) (Kind) (Number)
Heat. System E pC _d Id—Type of Roofing Cow, a? Ext. Finish jMAscsvi TG. Int. Wall Finish
Use of Bldg. n&LI 1 4y AAid<44C C_ No. of Units Bedrooms 2 -
Ga rage
2Garage or Carport Attached A" L Private Detntched
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PLOT PLAN
aw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
prop ed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem ald water supply lines.
% .e NORTH State License No.
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tion submi'fte(V is correct /nd there are no other structures located
Owner o Agen Date
A-LANDUSE OR STRUC PERMIT MUST BE ON THE PREMISES BEFORE CONST
T,4 IS IS NOT A PERMIT.
iL _ . '")A, its DO NOT WRITE BELOW THIS LINE
this property except
COMMENCED.
Your street address will be 5 `Zy7��` ��-The zone is
Sewage Permit Number Issued Building Perm Receipt 7a� _ Issued
Form 523 Bldg. Code
22 I c-,/
Ind. Ins. Acct. No.
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REQUIRED
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Plumbing Permit
M
Heating Permit-
NSewage
Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
tion submi'fte(V is correct /nd there are no other structures located
Owner o Agen Date
A-LANDUSE OR STRUC PERMIT MUST BE ON THE PREMISES BEFORE CONST
T,4 IS IS NOT A PERMIT.
iL _ . '")A, its DO NOT WRITE BELOW THIS LINE
this property except
COMMENCED.
Your street address will be 5 `Zy7��` ��-The zone is
Sewage Permit Number Issued Building Perm Receipt 7a� _ Issued
Form 523 Bldg. Code
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