1972, 10-26 Permit App: J4864 Residence 2'4'04
° County Spokane, Washington
of Washin ton
17i CL BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
7 APPLICATION FOR LAND USE OR STRUCTURE PERMIT./ 0 0
GENERAL REQUIREMENTS PERMIT FEE_„__?3
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.
IS TE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set-back and ingress •
a d egress.
OUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
rformed 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.
eey, \.//_�C17t A PP,I (CANT FILL IN BELOW THIS LINEfir /�/r/ �-�i
Name of Owner .� - - a=�'� w_ .-� ••ddress / �� Phone`(��TY�J 7
Architect _ Phone Nag seer �� Phone
Contractor . . aiy/C_-C% Address Phone
Legal D sc ption of Pr perty (Give c mplete descrLip�tio�n from deed, tax receipt, etc.)
_ civej < --- =2-. - se Ci -41C__O -e-(2.-1 y/
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DESCRIPTION
DESCRIPTION OF WORK:New /Addition Remodel Moving Bldg.Zone 1 Fire Zone 3
Size of Lot Q ail-49--/- ' I K / 2._ 5-1 ewage System '4 �...V.I _ _ _ Stories
imensions (o./3 X .2r' CO-C�.eitc otalSq. Ft._ • r� Valuation o77S` -d —
oncrete,brick tc.) od ,
•ooms Baths �ment Foundation Const. __C �c_i /�- his lyimney, .�ti /
a .art, none) ��g ��Fireplace
(Kind) (Number)
Heat. System ,. •_. ype of Roofing . Ext. Finish // r '-/-, --.v nt. Wall Finish ...1 Al I' /.
Use of Bldg. /� �. _ _,� _.• t _A�� No. of Units Bedrooms
• Carport Attached -
/
PLOT PLAN Private Uetatched - ---
111111 •
Iraw 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 License No.
'--- iAcct. No.
5.-42_ Q__
REQUIRED
a *----4\--_Qx•Q____cv „z_ GA Plumbing Permit. Y-
(_ mHeating Permit /
"' T a
u+ p 8 N Sewage Permit
-i -1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ILI' SOUTH
hereby ert'fy in submitted is correct and there are no other structures located on this property except
as wn. ,
; /
Owner or A ent Date
LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
/A
Cid2 DO NOT WRITE BELOW THIS LINE
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Your street address will be '9'. �// .e zone is / - `� / ,`r
Sewage Permit Number /
Issued Building Perm Receipt 7 IIssued
a 4 Remarks ' Gc,L
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Form 523 Bldg. Code
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