1971, 05-10 Permit App: I4350 Addition4111 1111
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT /P
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.
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 -RACK 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. Wherethestructure 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__Oey
Architect n Phone
Contractor eh iew //p $ .161 e/0 N y �,
Legal Description of Property (Give complete
.Zo+ 0 I5loek Pie Oetnet.
.50F +0 '7R N5 Atli•
p, OVQ Address N. /105"Me Dona lel kilihone
DESCRIPTION OF WORK: plew
Size of Lot '
gineer Phone
Address 44 `Lt/O %l AR.9//P e,/76e. NdPhoneWn (-,-7017
description from deed, tax receipt,✓etc.)
N rz .cxe. /v 20'« Eke R. --09 i a tcre 0- ih?. 9
£5 Mf
Addition Remodel
Moving
Const. FQ+aM'e Dimensions
(Frame, concrete, brick, etc.)
Rooms/ Baths Basement
(Full; part, none)
Heat. System Type of Roofing
Use of Bldg. ,add 4 n L /v /iv y
i420X /60
Foundation Const
,e 0 41
Bldg. Zone Fire Zone
Sewage System Stories
Total Sq. Ft. l 9z Valuation 29 2:0 a
3
�N •
Chimney _ Fireplace
(Kind) (Number)
Ext Finish 5-XiXkr 5 Int. Wall Finish ,0e,j'w4 /%
No of Units Bedrooms
Private Detatched
Garsge or Carport Attached
PLOT PLAN
aw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
ed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
and water supply lines.
NORTH
VV I°(1441,
SOUTH
I hereby, certify information submitted is correct and
as shown.
D
N
N
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
there are no other structures
Owner or Agent
located on this property except
414- /O— %/
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be if
Sewage Permit Number Issued
Remarks
DO NOT WRI
ELOW THIS 11NE
Building Permit
e zone is
Receipt Issue
v76
Form 523 Bldg. Code