1971, 04-27 Permit App: I4166 Residence County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT � f Os L)----
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 tbr‘,
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 and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County`EngiAeer. --
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 -G 6
Name of Owner {=� -`-e-C-/-2.----1- Address ' - - ne 4/0---1 7'� -`
Architect Pho Engineer , ' Phone C_
Contractor -"-Z-- Address Phone l-•,r C 3ç ,
Legal Description of P og.srtyJ Give complete description from deed, tax receipt, etc.) The S. 401 of Lot 3, the N.
281 of Lot 4, The N. 281 of t.hc E._ 131 of Tot 13 and the S- 401 of F� 131 of Lot 14, -
Block 2, Valley Vista �1J, 2
DESCRIPTION OF WORK:New AV Addition Remodel Moving Bld..Zone Fire Zone 3 _.
Size of--L--ott ' X / -- -7 ,9Sewage System ,r- ries
Const. 7"o� 6ci.--4,2•z Dimensions 12-y i t!S' Total Sq.Ft. 7 - Valuation /61- 1c2L-)
(Frame,concrete,brick,etc.) / /
Rooms 6.— /
Baths Baseme - Foundation Const. �,`--a�"� C-1 t.-- Chimney Fireplace
5-/7.-. (Full, part'/none) (Kind) i (Number)
Heat. SystenyType of Roofing �'��f��-r r�/) Ext. Finish // Int. Wall Finish •I' _____c
Use of Bldg. i ._a- C -,. 2° j
No. of Units Bed . ms
Garage or Carport Attached Private Detatched
CPLOT 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 and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH State Lice -) No. 1
Alir&.
' Ino. Ins. Acct. No. I
,j> '''' - -de- (-12-e16 " -- .
REQUIRED
Plumbing Permit
in Heating Permit
m
to N Sewage Permit
-I -4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up �..
Plans Mailed
OUTH
I hereby cert info mat' submitted is correct and there are no other structures locate. on this property except
as shown. i,
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT ST BE ON THE PREMISES BEFORE CO STRUCTION COMMENCES
THIS IS NOT A PERMIT.
D�Oj NOT WRITE BELOW THIS LIN
Your street address will be b -3 /'�C= _ .0 c
se zone i - �"
Sewage Permit Number Issued / • ding Permitc4 / /('J4' Receipt 9'- ued
Remarks
Form 523 Bldg. Code
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Property Survey ars]. Legal Description
°--y\ )—S2k- IC The South 40 feet of Lot 3 Block 2 Valley Vista Subdivision Except tha
......A_.0- East 30 foot thereof.
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The North 28 feet of Lot t Block 2 Valley Vista Subdivision Except the 1 '
East 30 feet thereof. *.:- •
45
28
The North 28 feet of the East 13 feet of Lot 13 Block 2 Valley Vista V;;:i.:Polis"-TGE40?/•\it'4"
Subdivision.
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The South 40 feet of the East 13 feet of Lot 1t Block 2 Valley /0
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Vista Subdivision. .. .,_, '--t,--;_---). •.„-• ,,-. f
JO-S-01-1 .1.. DICKINSON'
PROFESSIONAL LANE) SURVEYOR
For: E. 9516 MONTGOMERY
iv:r.. Ted. Gunning B.A-SI c 1t6 H 4100 /V, /8D3 i?ay...,.., itc./ )
N., 1825 Raymond Rd.
7