1972, 09-28 Permit App: J4669 Residence, Renewal of J0696 County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT f.5
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 ost zones and under most circumstances, a set-back from the front property line, of at
least 25' is required, a 5' side ard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the st a 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.
'' !cc) / •' . -% APP' •• NT FILL IN BELOW THIS LINE
. m f Owner f / �P�/� �4111M-11,1r.. 4.6. ••:ress _ -'- d -. 'I -- ,• , one� �-�7�
Architect Alone Engineer Phone
Contractor Address Phone
Legal Description of Property (Give complete descripti.,' from de:d, tax receipt, :tc.) If
.i
/ (/lucre«/
DESCRIPTION OF W• •K:New fes.A.•ition Remodel Moving Bldg.Zone / Fire Zone
Size of Lo dX /6 " Sewage System 90511Stories
Co•_ . , ..'_., ....1_ •imensions c..- /e- ? r 7 Total Sq.Ft. .S'r e 7'- Valuation ,
(Fra.--,c9ncrete,brick,et .) /// ,x 26
R•..- s lei Baths 7 Base : _ . . . Foundation Const. x/1-1 -e.-/ Chimney - Fireplace
(Full, par one) (Kind) (Number)
Heat. Syste. T 4+• of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. '���.�_ _�� - d— No. of Units Bedrooms
Aparport ••ttached c„,_,,,,, Private Detatched i��L�
PLOT PLAN
aw 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.
Ind. Ins. Acct. No.
9 CI
r / i REQUIRED
/ /i '," i / tzlPlumbing Permit( ---4-
m Heating Permit
m
v► H Sewage Permit
♦ -1
Plans Receiv•'
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I •reby certify informatio.isubmi ed is correct and there are no other structures located on this pre -operty except
as show 1
A .� �. .' _ — _ az_Ownef or Agent) Date
A L • ND USE OR ST �� CTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
` IL/ ,_0 DO NOT WRITE BELOW THIS LINE
/�' //
Your street address will be _ "��. / Z-- ,e zone is // •� -, -I i
Sewage Permit Number Issued Build ing4 mit ( 54i6 Receipt Issued
Remarks
Form 523 Bldg. Code