1972, 10-26 Permit App: J4900 Residence• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201'.,
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL' REQUIREMENTS PERMIT FEE ":2
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.
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. 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. .¢l l dirr-scnt.c.. +,.+) Pte.- Address - -.-U Rhone
gineer Phone
Contractor Address Phone
Architect Phone
Legal Description of Proprty(G've complete description from deed, tax receipt, etc.. --" // FO '
(Y)I S )/[/ 0 1i / A
DESCRIPTION OF WORK: New ./-'"----"Addition
Size of Lot 8-a Y- / 1 2-
Const rr- .-----A • Dimensions
JV. s_,,,,„/_f60
(Frame, concrete, brie , etc.) jj'�''
Rooms Baths I Basement rim
(Full, part, none)
Heat. System 60 o' AA Type of Roofing
tJ l O"
Remodel
A- ak
Foundation Const
Use of Bldg. a ng. it.. o
Garage or Carport Attached
yr I%raFt�/do ,
Moving Bldg. Zone / Fire Zone
Sewage System S T Stories /9/
Total Sq Ft / / 7 .6 Valuation 7,r -
Con r r -e 7 Chimney Fireplace 0
yQ (Kind) (Number
Ext. Finish 9f �C "7 . Int Wall Finish
No. of Units Bedrooms
Private Dutulchcd
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 a'id streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH
SOUTH
I hereby cer 'fy information sub fitted is correct and there are
st as shown.' /
T
rn
N
N
State License No.
gnd. ins. Acct. No.
REQUIRED
7
Plumbing Permit
Heating Permit
Sewage Permit
(
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
�9
no other structures located on this property except
/de9h-•2
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIMUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
Your street address will be 3 . Q
Sewage Permit Numb Issued Building Perm Issued
Remarks 4 : 11 4%75
DO NOT WRITE BELOW THIS LINE
e zone is
Receipt 771>
Foran 523 Bldg. Code
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9
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'
JOSEPH L. DICKINSON
PROFESSIONAL ,LAND. SURVEYOR ;3-
E.' 12121 MANSFIELD +
SPOKANE; WASHINGTON 99206
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