1972, 03-28 Permit App: J2376 ResidenceAPPROVED AS NOTED
Spokane County Bldg. Code Dept.
Date - 2_-
•
by
1
tinily of Spokane; Washington
DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT v 6
GENERAL REQUIREMENTS PERMIT FEEX
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 build iog or structure already erected, or to change a land use. Construction must conform with the
Spokane County But lding 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 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
a O
Name of owner r4/- 6-0111 rarto rs Address V) -L, /1c//FJ LAK e. � R
Arch iof Owner
1�------w �y_nr idcri--y one A[5'-6 YY6
/✓t5 -i -c•- 1155! Phon�l7-V VVA?Pngineer Phone
Contractor Address - Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
--- L01 y 8/ocsr ry N/// tiA'Ew Fstate,s _2-7ny3-/OO9
DESCRIPTION OF WORK: New Addition
Size of Lot 4'%[x )27 J
Const Fria ..-1 P Dimensions y y X 2-7 (94/3i a s
(Frame, concrete, brick, etc.)
Rooms_h_Baths 2- Basement rFoundation Const.
Ft+ (Full, part, none)
Heat. System t ' c Pine IncG'ype of Roofing-
Use of Bldg. Rp c J N C ,P /
Garage or Carport Attached O -a r a - e /( DT- e In e (/
Remodel Moving Bldg. Zone
Sewage System f� Stories /
Total Sq. Ft. ' 3+ - Valuation P.7- 4"-4"-10-
Fire Zone
J7//
C Cy, fes
/1 ti a r Ext Finish 7 / - ( /
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
Chimney ` Fireplace 1
(Kind) (Number)
Int Wall Finish Dry K-a,f
No. of Units Bedrooms —3_
Private Detatched
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
/c -' / 2 i NORTH
C..
State License No.
22 3- a/ - 2V
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ONTHEPREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number Issued
Remarks
%.i
Building Pe'rmi,
e zone 1s
,frres- ..e0
Receipt Is
d
,4.9'gccsal (0,---d-1 a�
Form 523 Bldg. Coda