1975, 12-08 Permit App: L2256 Residence1
Canty of Spokane, Was!gfon
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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 -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
6-0
Name of Owner fir.... Address � — ' Phone
Architect , Address ._' . ' 0 a Phone
Engineer n Address Phone
Contractor Address
Phone
J�ggaI Description P operty (Give complete description from dee �ieceipt etc )
a11/L-GL-C�+ 1
DESCRIPTION OF WORK: New
Size of Lot
/ , o i v'
Addition
Remodel Moving Bldg. Zone / Fire Z
Sewage System S 7 onst.
Total Sq. Ft / 5 Valuation
Stories Dimensions cA(0 �n
Rooms Baths Basement Foundation Const
�--L Chimney Fireplace
Fu t, part, no ) (Kind) (Number
/lOr
Heat. System ( Type of Roofing t.--,(5-)e\--1---t'Ext. Finish 9O Int. Wall Finish -*`47--'g-
No. of Units _ Bedrooms
Use of Bldg.
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
NORTH
✓ 0
%Q
/ aIRESIDENTIAL - COMMERCIAL
!.4
32
.231-3
,
1
4-f
I her
as shown,
SOUTH
REQUIRED
Plumbing Permit
rn Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
certify information submi ed s orrect and there are no other structures located on this property except
/0.
Owner or Agent
A LAND USE OR STRUCTURE
THIS IS NOT A PERMIT.
144/,441
Date
IT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT RITE BELOW THIS LINE
Your street address will be / a / r -
Sewage Permit Number Issued Building Permit L/,,2') -41r, Receipt /660) Issued
Remarks
The zone is
Form 523 Bldg. Code
PERMIT NO.
Name
Addre.ls of Proposed Site
Type (if Use
Numbur of Bedrooms
Water Supply
SPOKANE COUNTY HEALTH DISTRICT
E. 0. PLOEGER, M. D., M.P.H., HEALTH OFFICER
N. 819 Jefferson Street
Spokane, Washington 99201
,1/b r r�..42v70)
DATE
No. A 16837
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
,,1"17D co ( /.
Addressld Phono N0,0162254. --Cc S7 9
Bu,ld ng Capacity
Septic tank capacity 0
Length of disposal field / ?4✓
)
s basement for building planned/
r.:nacity Other
City Welt, Spring). Orywell
gals. Style of tack
Absorption Pits f D i l Lear h Bel
(L) 9hnw relative loCation of. Proposed house, septic 'Atoll,
Moose! spose! fled, weir pride ere other out buildlree•
(2) Make nate e( any heavy slope Of troirnpy area or any
other important topagrephic detail*.
Installer
Final Inspecllon Date
Remarks:
CONTRACTOR
.
/a
i1 � 7
PA—Li 4P4111"V.f.
^6, :017
FORM 344 ROy, M*ALTH
For Spokane County Health District