1972, 09-15 Permit App: J4540 Addition ill-1 )%c
1 County of Spokane, Washington
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BUILDING CODES DEPARTMENT, COURTHOUSE. SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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 must 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 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 �`-�^AOS ��� / eti ' a� J Address �n .7 Phone �/u C[ — 37/er
Architect a Engineer Phone
Contractor �,0,4_p_,,,c_c, ddress l'J / 0 Q /0 1 I
Phone
i
Legal
.�DDescrip ion of Property ( 've com.lete description from deed, ax rece'pt, etc.) _ _ / 3
.rte_ r — - #1._.--,_%i '/ _ _ /, i
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DESCRIP ION OF WORK:New A.(ition Remodel Movin: ,4, Bldg.Zone / Fire Zone.
Size of Lot I . 4 — Sewage System / -' . Stories
Const. Dimensions = -_-_-_--.---7,-._T Total Sq.Ft. .2 8 $ Valuation, !r (� �
(Frame,concrete,brick,etc.) f /T tel/
Rooms Baths ell, part,ent Foundation Const. ~ . __ - Chimney Fireplace
"'` (1 ull, none) �- f (Kind) (Number)
Heat: ystem_l�oz�Type of Roofing • Ext. Finish Int. Wall Finish
;Y of Bldg. 'e, zi_O. .1,2--,Q S,,,/y- No. of Units Bedrooms
1rag. or Carport Attached Private Detatched
PLOT PLAN AP/ eft440
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craw sketch with dimensions showing: (1) property lines; (2) street or road., __.:. , .. , oca . •-
.• oposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH /6 0 State License No.
Cv°47
Ind. Ins. Acct. No.
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,,y�I ' A',
C/ \ REQUIRED
v ) �T,, / Plumbing Permit L =
4fr------ m Heating Permit
m , , X F
cmN Sewage Permit
—Ir— — ( , 'I
p Plans Received
Plans Checked -4.-.AigIIIIIIII,
Plans Returned
Plans Picked Up
1
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures
located onproperty except
as show,
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_
Ownsro'or
Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT RITE BELOW THIS LIi Al
4111. 410IF
Your street address will be ja a •w. ,. j_i� / ,..,� A... , .e zone is / 1/ �`.i/
Sewage Permit Number Issued Building Permit 1 ti SVC)U Receipt Issued
Remarks '
IV' ��� /% 4/ 110Y A
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i_. 9\143 (i
U.;' Form 523 Bldg. Code
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