1973, 03-28 Permit App: K997 Poolr —a --
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County of Spokane Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMITc(r
GENERAL REQUIREMENTS PERMIT FEE.._-
PERMIT REQUIRED. A land use or structure permit 1s 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 47235.
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 o
ddress /V (p//) eillpry .Cid Phone
Architect /(Phone- Engineer 47. -4±C -4-r-7
, -1 Phone
Contractor d�,,,,, n,', Z...J .4 _- Address 9.6 �d4 0._) Ad Phone
����� -Su6 4599 Fitr .//'iRZ',F-FYr 59.1
t P7.s'/3 - 6 411 q
Moving Bldg. Zone Fire Zone
Sewage System Stories
Total Sq. Ft. t4 "' Valuation cV' 4d' ,Tt)
Name of Owner
Legal Descrlpti n of Property (dive complete description from deed, tax receipt, etc.)
fa,t* -6 cLa-4 'a Qrt c,
'L 9.?6•S-6'
DESCRIPTION OF WORK- New Addition Remodel
Size of Lot 90 .' gtY9
Const. a 3 Dimensions /f0 't. -
(Frameeoncrete, brick, etc.)
Rooms Baths Basement Foundation Const. Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System 1 Type of Roofing Ext. Finish Int. Wall Finish
.
Use of Bldg. lede/JX.f'Krifere—,p+� �efere—,No of Units Bedrooms
Garage or Carport Attached _ Private Detatched
PLOT 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
14
/90
SOUTH
I hereby certify information submitted is correct and -there
as shown.4-1,4al 443t1 1
//,,(( er or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE
THIS IS NOT A PERMIT.
State Lice ,se No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
are no other structures located on this property except
3 2 g5--7-3
Date
PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
Your street address will be Z,/2)i ��e zone is
Sewage Permit Number Issued Building Permit ay �� Receipt
Remarks /�-(
Form 523 Bldg. Code