1969, 08-22 Permit App: H4677 Relocate ResidenION
County of Spokane. Washington " 3a ° Q
BUILDING CODES DEPA
RTMENT, COURTHOUSE, SPOKANE, WASHINGT 9940
APPLICATION FOR LAND USE OR STRUCTURE EPMRMI
T
GENERAL REQUIREMENTS or
IT FEE
PERMIT rE@alRID•anlistructure
arscyucResolution
erect
nrthe
kind
or ter any building orstrutureleadyereted, ortohangealand use. Constructionmust conform with
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
the s Water
supply shoulders be
County Roads, permissionand State ealth must bepobtained fromre theork on Countyater Engineer'stOfficeisturbs
the surface,
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.23 .
SeastACK FROMiPROPERTY LINES.
side zones
side yardrfromtacflankingnstreet,sandback from 25' rearhe yardont areprequiredline, of at
leastSTATE 25' is required, clearance must be obtained pertaining to set -back and ingress
HIGHWAYS. Where the structure abuts a State Highway,
and egress.
COUNTY eddOinSaccordanceswithtstakes.of-ay may Points of ingressperformed
egressnmuststaked
approved byCounty
theRoad
County Engineer.
MOVING Department
work must be
Performed
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.
the land
whichIareVenforcce enforceable throughBuilders
civiluld check action. Countysions Officialscovenants
not bringdedications
toand
enforceeents covenantslng or dedications.
which
/� / APPLICANT FILL IN BELOW THIS LINE
Name of Owner-�e"�-
J! �� i/ a4-Q_A dress Phone
� � y � �, Phone
Architect T� Phone Engineer
Contractor 0-114---‘'`C-0 Address
�o /76 c, 7 �1 Phone 2 6- 6 2✓ 3
Leg Descripti of Property (Give complete description from deed, tax receipt, etc.) o
Bldg. Zone ' / Fire Zone
DESCRIPTION OF WORK: Nevem Addition Remodel Moving / Ci �, k Stories
Const. Dimensions yD ,. Size of of .-�- q q 4( k oSewage System
/ 4„1 `-'1 'Dotal Sq. Ft. `Valuation .!L
(Pram ,I concrete, brick, etc.) �J Chimney Fireplace
Rooms & Baths
Basement /� tha--Foundation Const (Kind) (Number)
2 -(Full, part, none)
Heat. System, Type e of Roofing Ext. Finish Int. Wall Finish
No. of Units Bedrooms
tldg _ .. i� A v
C- >
, Lo -r, PLOT PLAN
d
Draw sketchils with (i)mdistancestowing: (1) property property lines ardlines; (2) streets; (5)reet or dimensions of buildings;(3) (6)llocationof ofesewagegand
sys-
proposed buildings;
tem and water supply lines.
m
NORTH
I here
as shown
SOUTH
ify information submitttdcorrect
Owner of Age
State License No.
Ind. Ins. Acct. No.
1�t.a�c.lo
a� REQUIRE
` lum-3tg Permit
m Heating Permit
N Sewage Permit
-a
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
and there are no other structures located on this property except
216
Date
A LAND USE OR STRUCTUJIPERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIi, LINE
Your street address will be J/ y'�►`�'� The zone is
Sewage Permit Number Issued Building Permit Receipt Issued
Remarks
elk” 1 6^ 6
ztt2
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