1971, 04-27 Permit App: I4161 Residence 4
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR .STRUCTURE PERMIT �c ,
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.
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 a+•d 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 7, '� -c
Name of Owner7�e .e- -e-%-- ddress C72 2//2 ei , one`Z e / 7 -,----Sar
Architect Phone Engineer .- Phone
Contractor '- -J-7(—,C ': Address Phone �j
Legal Description..�, of Property (Give co�rnglete description from deed, tax resei t, etc.)7. ' 3:2' _.t4 361
26, `e} X 7,040 _ 0 .30,' /- �l :ye ' '/3 `e. 4e/ 3 ' ? 47' jl
DESCRIPTION 9F WORK:New_ •- Addition Remodel Moving Bld...Zone Fire Zone
Size of Lo �1 7-• {%' Sewage Syste _ .1 - " tories� 7
Const. Dimensions 4 7 Total Sq. Ft. -- Valuation
(Fra e,concrete,brick,etc.)
('--��-
Rooms Baths Baseme _
Foundation Const. ZAz - Chimney Fire lace
C (Full, par one) (Kind) (Number) �;�,
Heat. Syste T of Roofing-`�---9 Ext. Finish��/'// Int. Wall Finish r` 1 �-- �r
�' :.
Use of Bldg. --' e'- �'z ,. No. of Units Bedt �a
Garage or Carport Attached Private Detatched
PLOT PLAN
Z,traw 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.
, NORTH State Lic se No.
Ind. Ins. Acct. No.
A (
REQUIRED
Plumbing Permit
m Heating Permit
in a
y N Sewage Permit
-I -1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify or ,, i.. -ubmitted is correct and there are no other structures located on this property except
as show
n. X /
A �tr ✓
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT ST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be • / f 2� L. -
/ C °,a zone''//is
C:---e - -"C2‘6'
Sewage Permit Number Issued B. ding Permit /i ,f Receipt"Tg. Issued
Remarks
Form 523 Bldg. Code
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Property Survey and L gal Description
The South 32 foot of Lot L B • ' v: • - -. -,:)••• • • •s-i-on-Except the
..„0.r....,.. ,_a,
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East 30 feet thereof. • . ,e,� L. C/1, A
The North foot of Lot B : . = '. .• ' f7C5 �C't /��� kr., ,
5 on N;xcept the .F.5,::)- o
East .30 feet thereof. ..F.5,::)„/- -
ice ;, :.,r
The North fi feet of the East 13 feet of Lot 12 ,Block 2 Valley Vista 6 03i:6
Subdivision. *::f GST 4'::7 24,4:-'s'`.%4..4
"'d -- "
The South 32 foot of tho East 13 feet of Lot 13 Block 2 Valloy Vista ts2'VAr, L�-.
Su bd ivis ion.
For: -0...,1,......4 e ,c 4... )-� t.l `Lv
_C_,.
Mr. Ted Gunning Basic Ranch #700 JOSEPH L. DICKINSON
N.• 1819 Raymond Rd. ER FESSI3NAL LAND SURVEYOR
`J�q 9316 MONTGOMERY
1. Sp�lcann, Wash. 99206