1971, 06-25 Permit App: I4867 Residence0 0
County of Spokane. Washington 60
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
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 mast conform with the
Spokane 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.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47235.
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 q 4 �z/ 6
Name of Owner
Architectr� �L_-�p
Contractor Gt/
I
s
Phone JEngineer Phone
Address li 21. a,�_ Phone,,
DESCRIPTION OF WORK: New. L'� Addition Remodel Moving Bldg. Zone Fire ZoneL_._L_�
Size of Lot a Sewage System _ Storiesp_I
Const. F K� s3,� . Dimensions �� Z Total Sq. Ft. V� aluation 96L
(Frame, co rete, brick, etc.) &g
Rooms Baths Z Basement Foundation Const. - Chimney Fireplace 2 -
(Full, part, none) (Kind) (Number)
Heat. System Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. No. of Units ___ — Bedrooms
Garage or Carport Attached Private Detatched
PLOT PLAN
S O U T)I
I he by certify information submitted is correct and there are no other structures located on this property except
as sho
L .(.� S" 7
Owner or AgentDate
A LAND USE OR STRUCTURE PER IT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be �i a zone i�"
Sewage Permit Number I sued Build g PermitqAM Receipt , �o� Issue
n�d/
Remarks �.i�`-`. ��- .,, �� s� J
LA -4,2-
Form 523 Bldg. Code
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.
State License No.
NORTH
;Z� Z 3 D 1 `fi —1
r
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
ns
Heating Permit
N
N
Sewage Permit
GWJ714
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
p
Plans Mailed
S O U T)I
I he by certify information submitted is correct and there are no other structures located on this property except
as sho
L .(.� S" 7
Owner or AgentDate
A LAND USE OR STRUCTURE PER IT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be �i a zone i�"
Sewage Permit Number I sued Build g PermitqAM Receipt , �o� Issue
n�d/
Remarks �.i�`-`. ��- .,, �� s� J
LA -4,2-
Form 523 Bldg. Code